J Gastric Cancer.  2010 Dec;10(4):254-258.

Gastric Lipomatosis

• Jeong IH
• Maeng YH

Abstract

Gastric lipomatosis is an extremely rare condition. We present a case of a 69-year-old woman admitted with epigastric soreness. Computerized tomography (CT) revealed extrinsically compressing, fat-containing mass lesions on the entire gastric wall of the antrum and body except for the lesser curvature. A subtotal gastrectomy was performed. Pathology findings confirmed a gastric lipomatosis with multiple gastric ulcerations and extensive disruptions of the muscular layers. This case and reports of other gastric lipomatosis cases indicate that CT should be used to characterize large submucosal masses because CT can show the specific nature and extent of the disease. We believe that surgical treatment is the most appropriate treatment for symptomatic gastric lipomatosis that shows extensive gastric involvement, or when there are multiple gastric lipomas.

Keyword

Stomach neoplasms; Lipomatosis; Gastrectomy

MeSH Terms

Aged
Female
Gastrectomy
Humans
Lipoma
Lipomatosis
Stomach Neoplasms
Stomach Ulcer

Figure

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  Fig. 1 Gastroscopy findings (A) and UGI study (B). Note the extrinsic compressing mass lesion on the anterior wall-greater curvature-posterior wall of the antrum and body, and the ulceration (arrows).

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  Fig. 2 CT (A and B) and EUS (C) radiology findings. Note the huge fat-containing mass lesion around the gastric wall except for the lesser curvature, from the gastric midbody to the antrum. The lesions (arrows) appeared as well-circumscribed areas of fatty density with an attenuation ranging from -70 to -120 H. The lesion originated at the submucosal layer, had a depth of about 2.7 cm and was homogeneously hyperechoic on EUS findings.

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  Fig. 3 Gross pathology findings of the resected specimen. (A) Examination of the intact specimen. Note the multiple nodules of deep adipose tissue without encapsulation, and the mucosal surface with several ulcers which was diffusely elevated by the submucosal mass (approximately 16×16 cm) that almost encircled the gastric wall. (B) Examination of the specimen following sectioning. Note the deep adipose tissue mainly in the submucosa, and adipose tissue diffusely disrupting the muscular wall.

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  Fig. 4 Photomicrographic findings. Note the mature adipocytes replacing the submucosa and the muscle layer of the stomach (A: H&E, ×10 and B: H&E, ×200)

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