Gastric lipomas: a case series and review of a rare tumor

Abstract

The purpose of the study was to investigate and review the multimodality imaging findings of gastric lipomas. Seven patients with gastric lipomas identified by CT imaging at a single institution between 2003 and 2017 were retrospectively evaluated. Patient demographics, clinical presentation, non-invasive imaging, endoscopic, and pathological findings were recorded.The most common location for gastric lipoma was the gastric antrum (3/7). The mean lipoma size was 2.7 cm ± 0.8 cm. Six out of seven lipomas demonstrated homogenous fat attenuation with mean Hounsfield units (HU) between −80 and −120. A single lipoma measuring −50 HU demonstrated soft tissue septations. In addition to routine CT and MRI, gastric lipomas were diagnosed on the low-dose CT protocols such as coronary calcium scoring, renal stone, and positron emission tomography-CT (PET-CT). Our CT findings corroborate those reported previously. Soft tissue septations visualized in one lesion likely represented post-biopsy changes, adding this etiology to a differential which previously included only ulceration. Cases characterized by MRI are rare in the literature, and our study provides one such example. To our knowledge this study represents the first documentation of gastric lipomas on PET-CT and other low-dose CT imaging protocols.

Gastric lipoma of the pylorus – case report of an incidental finding

“…Well-differentiated liposarcomas account for 40% of all liposarcomas. Their peak incidence is between the 5th and 7th decades [2 , 7 , 13 , 14] .…”

Enucleation of a giant symptomatic gastric lipoma, a safe surgical approach

“…In the case of gastric lipoma, it strongly suggests the diagnosis by visualization of a well-circumscribed homogeneous mass with fat density ranging between −80 and −120 Hounsfield units. These values are considered pathognomonic and suggest a diagnosis of gastric lipoma, by falling in the expected value range for adipose tissue [ 4 , 5 ]. EUS is another useful imaging study to confirm the hypothesis of gastric lipoma.…”

“…Giant gastric lipomas (≥4 cm) are even more unusual [ 3 ]. The vast majority of gastric lipomas are small and discovered incidentally during endoscopic or radiology evaluations [ 4 , 5 ]. The small asymptomatic lesions can be followed without intervention [ 6 ].…”

Giant gastric lipoma presenting with melaena: A case report and review of the literature

“…The antrum was the most common location in their case series, as was in the present case. They concluded that CT is the diagnostic gold standard, surpassing other imaging studies, endoscopy, and even routine endoscopic biopsy in both sensitivity and specificity [16].…”