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Introduction: The purpose of this case series was to review a rare subset of tumors known as gastric lipomas, which are typically found incidentally. The motivation for this study arose from the identification of 2 cases within our institution in a short period. Case Presentation: The study involved a review of the diagnosis and management of 2 patients presenting with gastric lipomas at our institution after symptoms of gastrointestinal bleeding. With the advent of new radiologic investigations such as computed tomography and magnetic resonance imaging and advances in endoscopy, there are new approaches to identifying and managing these tumors. On further evaluation of the literature, we found that despite the availability of minimally invasive endoscopic techniques such as mucosal resection and submucosal dissection in the setting of large tumors, most patients tend to have to resort to surgical management. Conclusion: This case series underscores the rarity of gastric lipomas and their often-incidental discovery. Further investigation into endoscopic approaches for managing these tumors is needed, and additionally, there is a need to explore a potential association between gastric lipomas and malignancy, as chronic inflammation of the overlying mucosa may play a significant role.

Introduction: The purpose of this case series was to review a rare subset of tumors known as gastric lipomas, which are typically found incidentally. The motivation for this study arose from the identification of 2 cases within our institution in a short period. Case Presentation: The study involved a review of the diagnosis and management of 2 patients presenting with gastric lipomas at our institution after symptoms of gastrointestinal bleeding. With the advent of new radiologic investigations such as computed tomography and magnetic resonance imaging and advances in endoscopy, there are new approaches to identifying and managing these tumors. On further evaluation of the literature, we found that despite the availability of minimally invasive endoscopic techniques such as mucosal resection and submucosal dissection in the setting of large tumors, most patients tend to have to resort to surgical management. Conclusion: This case series underscores the rarity of gastric lipomas and their often-incidental discovery. Further investigation into endoscopic approaches for managing these tumors is needed, and additionally, there is a need to explore a potential association between gastric lipomas and malignancy, as chronic inflammation of the overlying mucosa may play a significant role. [ABSTRACT FROM AUTHOR]

Gastrointestinal (GI) polyps are uncommon connective tissue or epithelial tumors that typically affect the colon but can affect any part of the digestive system, from the esophagus to the ano‑rectum. They may be solitary or multiple, sporadic or inherited, benign or malignant. The risk of malignancy is strongly associated with the type and size of the polyp. GI lipomas and GI stromal tumors are both rare causes of GI polyps which may present with GI hemorrhage or obstruction. Most polyps are asymptomatic and are detected incidentally when patients are being worked up for unrelated symptoms. When present, the symptoms might vary, but the most frequent ones are abdominal pain, GI bleeding, intussusceptions, and intestinal obstruction. A surgeon with keen clinical suspicion can make an early diagnosis to help avoid serious inherent complications. [ABSTRACT FROM AUTHOR]

Background: Lipomas are common harmless tumors that are created in the colon in the gastrointestinal tract. The aim of this study was to report a case study on gastrointestinal lipoma with GIB. Case Presentation: A 38-year-old man was admitted to the hospital because of gastrointestinal bleeding for two months in December 2017. He had abdominal pain, dyspeptic disorders, vomiting, melena, and intermittent hematemesis without significant weight loss. Upper gastrointestinal endoscopy indicated a large subepithelial lesion in the antrum of the stomach with near-normal mucosa. Endoscopic ultrasound (EUS) showed a large well-defined heterogeneous mass-like lesion in the antrum of the stomach. A subtotal gastrectomy was done in the patient. The histology results of the separated samples presented a gastric lipoma. Conclusion: Gastric lipoma is often yellowish. It might ulcerate and bleed, but it does so, only rarely. It most frequently occurs as a solitary and smooth mass in the gastric antrum.

Gastric lipomas are rare submucosal tumours that account for less than 1 % of all stomach tumours. Despite their benign nature, they can lead to significant clinical manifestations such as gastric outlet obstruction and massive gastrointestinal haemorrhage. We report the case of a 50-year-old woman with no prior comorbidities, presenting with severe upper gastrointestinal bleeding. Diagnostic imaging and endoscopy identified a submucosal mass in the prepyloric area, later confirmed to be a gastric lipoma. The surgical intervention involved laparoscopic resection of the mass. This case underscores the importance of considering gastric lipomas in differential diagnoses of gastrointestinal bleeding. While often asymptomatic, their potential to cause acute complications necessitates awareness among clinicians. The management strategies range from observational approaches in asymptomatic cases to surgical excision in symptomatic cases. Gastric lipomas, though rare and often benign, can present with life-threatening complications. Accurate diagnosis using a combination of endoscopy and imaging, particularly CT scans, is critical for effective management. Surgical removal remains the definitive treatment for symptomatic lipomas, highlighting the need for a tailored approach based on the tumour's characteristics and location. • The article details a rare case of gastric lipoma presenting as massive upper gastrointestinal bleeding. • It emphasizes the diagnostic challenge, illustrating the use of endoscopy and CT imaging to accurately identify the submucosal mass. • The report outlines the successful laparoscopic resection, providing insights into surgical techniques and decision-making for treating symptomatic gastric lipomas. [ABSTRACT FROM AUTHOR]

Gastric lipomas, though rare, are noteworthy for their potential to cause upper gastrointestinal bleeding. This case report highlights the diagnostic and management challenges associated with this uncommon entity. We present a case of a 39-year-old male with epigastric pain and hematemesis, ultimately diagnosed with a gastric lipoma in the antrum. Endoscopy revealed a submucosal lesion with mucosal ulceration, confirmed by imaging studies. Surgical resection was performed, leading to a favorable outcome. Gastric lipomas are benign tumors that can present with gastrointestinal bleeding, abdominal pain, or obstruction. Diagnosis relies on imaging and endoscopic findings, with biopsy often inconclusive due to the submucosal location. Surgical resection is the preferred treatment for symptomatic or large lipomas, while observation may suffice for asymptomatic lesions. Gastric lipomas, although infrequent, pose a challenge for diagnosis, especially when associated with bleeding. Surgical resection remains the cornerstone of management for symptomatic or large lipomas, with observation being an option for asymptomatic lesions. • Gastric lipomas are uncommon mesenchymal tumors, constituting less than 1 % of all gastric tumors. • A gastric lipoma is a rare tumor that can cause bleeding. • The management of asymptomatic gastric lipomas can be performed only by observation. • Traditionally management of symptomatic gastric lipomas is endoscopic resection in small lesions. [ABSTRACT FROM AUTHOR]

Gastric lipomas are very rare benign tumors. Only around 217 cases have been reported. Most gastric lipomas are found incidentally; however, larger neoplasms can be symptomatic. The presented 64 years old male with incidental finding of pyloric lipoma adds another example to the few documented in the literature. The patient had symptoms of breath shortness and lack of energy two months after COVID 19 pneumonia. A low dose CT scan with iodine contrast enhancement of the chest and upper abdomen led to the diagnose. The diagnosis of gastric lipoma can be achieved through diagnostic imaging or the combination of endoscopic techniques. Treatment can be carried out by endoscopy, robotic or classical surgery.

Teaching Point: Gastric lipomas are very rare and generally asymptomatic benign tumors; however, they can manifest as life-threatening complications, readily diagnosed by CT.

Background: Lipomas are common harmless tumors that are created in the colon in the gastrointestinal tract. The aim of this study was to report a case study on gastrointestinal lipoma with GIB. Case Presentation: A 38-year-old man was admitted to the hospital because of gastrointestinal bleeding for two months in December 2017. He had abdominal pain, dyspeptic disorders, vomiting, melena, and intermittent hematemesis without significant weight loss. Upper gastrointestinal endoscopy indicated a large subepithelial lesion in the antrum of the stomach with near-normal mucosa. Endoscopic ultrasound (EUS) showed a large well-defined heterogeneous mass-like lesion in the antrum of the stomach. A subtotal gastrectomy was done in the patient. The histology results of the separated samples presented a gastric lipoma. Conclusion: Gastric lipoma is often yellowish. It might ulcerate and bleed, but it does so, only rarely. It most frequently occurs as a solitary and smooth mass in the gastric antrum. [ABSTRACT FROM AUTHOR]

Gastric lipomas are very rare Tumours of Gastrointestinal Tract (GIT) accounting for about 2-3% of all benign gastric tumours. They are asymptomatic and discovered incidentally, most lipomas being submucosal. Authors hereby discuss a case of 50-yearold female patient who presented with abdominal pain and vomiting since four days. Transabdominal Ultrasound (TAUS) revealed long segment jejunojejunal intussusception and a hypoechoic lesion in the distal end of intussusception which was successfully treated by removing the lipoma along with the intussuscepted loop. Histopathological features revealed normal jejunal mucosa with a segment of intussusception and edematous submucosa which was thought to be submucosal lipoma or subserosal lipoma. As these lesions present at later dates, proper follow-up and early intervention is needed.

Teaching Point: Gastric lipomas are very rare and generally asymptomatic benign tumors; however, they can manifest as life-threatening complications, readily diagnosed by CT. [ABSTRACT FROM AUTHOR]

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Abstract Background Gastric lipomatosis is characterized by multiple gastric lipomas or a diffuse gastric infiltration of the submucosal or subserosal layer by the adipose tissue; diffuse-type gastric lipomatosis is an extremely rare condition. Here, we present the case of a patient with gastric lipomatosis treated by total gastrectomy. Case presentation A 54-year-old man diagnosed with gastric submucosal tumor in 2008 was referred to our hospital for further examination and treatment in September 2016. Upper gastrointestinal endoscopy revealed a submucosal tumor with an associated ulcer on the anterior wall of the lower body of the stomach. A compressing mass was observed on the anterior wall of the greater curvature and the posterior wall of the stomach. Following a biopsy of the submucosal tumor and ulcer, lipoma without malignancy was diagnosed by microscopy. A giant gastric lipoma was suspected because endoscopic ultrasound revealed a high-echoic lesion on the antral wall that extended to the stomach. Therefore, total gastrectomy was performed, and gastric lipomatosis was confirmed by a histological examination of the resected specimen. Conclusions Surgical treatment is a highly effective treatment for symptomatic gastric lipomatosis with extensive involvement or multiple lipomas and can be used for patient diagnosis.

Gastric lipomatosis is a condition characterized by the presence of multiple lipomas or diffuse mature adipose tissue infiltration within the gastric wall. The diffuse form is thought to be an extremely rare, with only few described cases. The lesion may be asymptomatic or associated with symptoms and signs depending on location and size. Treatment depends on clinical presentation, range and complications. In a symptomatic disease, it should be surgical, but conservative treatment is preferred for asymptomatic and solitary lesions. Among diagnostic methods, computed tomography and magnetic resonance imaging are thought to be the most valuable.

Highlights • Gastric lipomas may become symptomatic when ≥10 cm, at which point they are classified as giant gastric lipomas. • Giant gastric lipomas are extremely rare, with only 6 prior cases reported in the English worldwide literature since 1980. • Gastric lipoma density is similar to peripheral fat on CT, −80 to −120 Hounsfield units, which is nearly pathognomonic. • Circumferential excision of gastric lipomas with a clear margin of normal tissue is adequate for symptomatic resection. • Preservation of gastric continuity via gastrotomy and primary closure avoids complications of gastrojejunostomy. Abstract Introduction Lipomas are uncommon tumors of the gastrointestinal tract; gastric lipomas account for <1% of all gastric tumors encountered (Nickloes and Sutphin [1]). Giant gastric lipomas, defined as ≥10 cm, are exceedingly rare with only 6 cases reported since 1980 (Cappell et al., Termos et al., Singh et al., Ramaraj et al., Rao et al., Priyadarshi et al., Neto et al. [3–9]). We hereby present a case of a giant gastric lipoma that became symptomatic seven years after its initial identification and was excised preserving gastric continuity. Case presentation Our patient is a 58-year-old African American male with a 3 cm gastric mass incidentally found on CT in 2010. In September of 2017, the patient presented with severe epigastric pain, nausea, and vomiting. Abdominal CT scan revealed an increase in size of the patient's gastric lesion to 7.2 × 10.3 × 7.3 cm. He underwent an exploratory laparotomy with transverse anterior gastrotomy and primary closure. Pathologic examination revealed a 12 cm submucosal, well-circumscribed, non-encapsulated mass comprised of mature adipose tissue without atypia or mitotic figures, consistent with lipoma. Discussion The majority of gastric lipomas are asymptomatic, identified on CT scan as round/ovoid masses with low attenuation and homogenous appearance, measuring −80 to −120 Hounsfield units. These findings are nearly pathognomonic. Due to the benign nature of gastric lipomas, circumferential excision with a clear margin of normal tissue is adequate for symptomatic resection. This is the second report of giant gastric lipoma excised with continuity preserving partial gastrectomy, avoiding gastrojejunostomy complications. Conclusion Fatty tumors are rare in the gastrointestinal tract, yet lipomas must be on the differential when masses are found with Hounsfield units similar to peripheral fat. [ABSTRACT FROM AUTHOR]

Background: Gastric lipomatosis is characterized by multiple gastric lipomas or a diffuse gastric infiltration of the submucosal or subserosal layer by the adipose tissue; diffuse-type gastric lipomatosis is an extremely rare condition. Here, we present the case of a patient with gastric lipomatosis treated by total gastrectomy. Case presentation: A 54-year-old man diagnosed with gastric submucosal tumor in 2008 was referred to our hospital for further examination and treatment in September 2016. Upper gastrointestinal endoscopy revealed a submucosal tumor with an associated ulcer on the anterior wall of the lower body of the stomach. A compressing mass was observed on the anterior wall of the greater curvature and the posterior wall of the stomach. Following a biopsy of the submucosal tumor and ulcer, lipoma without malignancy was diagnosed by microscopy. A giant gastric lipoma was suspected because endoscopic ultrasound revealed a high-echoic lesion on the antral wall that extended to the stomach. Therefore, total gastrectomy was performed, and gastric lipomatosis was confirmed by a histological examination of the resected specimen. Conclusions: Surgical treatment is a highly effective treatment for symptomatic gastric lipomatosis with extensive involvement or multiple lipomas and can be used for patient diagnosis. [ABSTRACT FROM AUTHOR]

Introduction Gastric lipomas are unusual benign lesions and account for less than 1% of all tumours of the stomach and 5% of all gastrointestinal lipomas (Thompson et al.2003; Fernandez et al. 1983 [1,2] ). Although predominantly asymptomatic and indolent; they may present with gastric outlet obstruction and upper gastrointestinal (GI) bleeding owing to size and ulceration. Only a few cases have been reported, presenting large in size with massive GI bleeding (Alcalde Escribano et al. 1989; Johnson et al. 1981 [3,4] ). Presentation of case We report the case of a 62-year-old gentleman who presented to the emergency department with massive upper GI hemorrhage. He was initially resuscitated and stabilized. Later gastroscopy showed a large submucosal tumour (Fig. 1). Biopsy revealed adipose tissue. Computed tomography (CT) scan of the abdomen and pelvis showed a huge well defined oval soft tissue lesion measuring about 16 × 8 × 8 cm. The mass noted a homogenous fat density arising from the posterior wall of stomach with no extramural infiltration (Fig. 2). The tumour was completely enucleated through an explorative gastrotomy incision (Fig. 4). Discussion and conclusion Massive bleeding secondary to a giant gastric lipoma is a rare finding of a rare disease. The majority of cases in the literature result in major gastric resection. Familiarity with its radiological findings and a high index of suspicion can lead to proper diagnosis in the acute setting. If malignancy is carefully ruled out, stomach preserving surgery is an optimal treatment option. [ABSTRACT FROM AUTHOR]

We report a 12-year-old-boy with gastric lipoma. Upper gastrointestinal (GI) endoscopy with biopsy and abdominal computed tomogram (CT) scan revealed the diagnosis. Open surgical excision of the mass with stomach preservation was done. The clinical presentation and management are discussed and the literature reviewed here. This is the sixth pediatric case reported in the English literature.

Gastric lipomas are very rare Tumours of Gastrointestinal Tract (GIT) accounting for about 2-3% of all benign gastric tumours. They are asymptomatic and discovered incidentally, most lipomas being submucosal. Authors hereby discuss a case of 50-yearold female patient who presented with abdominal pain and vomiting since four days. Transabdominal Ultrasound (TAUS) revealed long segment jejunojejunal intussusception and a hypoechoic lesion in the distal end of intussusception which was successfully treated by removing the lipoma along with the intussuscepted loop. Histopathological features revealed normal jejunal mucosa with a segment of intussusception and edematous submucosa which was thought to be submucosal lipoma or subserosal lipoma. As these lesions present at later dates, proper follow-up and early intervention is needed. [ABSTRACT FROM AUTHOR]

Objective: To present a case of gastroduodenal lipomatosis associated with familial multiple lipomatosis (FML).Clinical Presentation and Intervention: A 58-year-old male presented with FML that manifested as multiple, painless, subcutaneous lipomas on his body; his mother had subcutaneous lipoma without a diagnosis of gastroduodenal lipomatosis. His lipid profile was normal. Abdominal computed tomography showed multiple, submucosal, polypoid lesions (of uniform density) of fat in the stomach and duodenum, and a small, similar lesion in the ileum.Conclusion: This case shows that gastrointestinal lipomatosis can manifest as FML. [ABSTRACT FROM AUTHOR]

Lipomas are found very rarely in the stomach, where they account for only 3% of benign gastric tumors. Here, we report a case of large gastric lipoma removed successfully by laparoscopic intragastric surgery. A 45-year-old woman with no symptoms was incidentally diagnosed with a yellowish submucosal gastric tumor, about 3 cm in diameter, in the prepyloric antrum by upper gastrointestinal endoscopy. Pathological findings of biopsy specimens showed no evidence of malignancy. Computed tomography showed an ovoid and well-circumscribed intramural mass, measuring 35 mm, which was of fat density. These findings suggested that the tumor was a lipoma that we felt should be treated, because large lipomas can give rise to gastrointestinal bleeding. We performed a laparoscopic intragastric enucleation for this tumor. Postoperatively, the tumor was confirmed pathologically to be a lipoma of the stomach. This laparoscopic procedure for benign non-epithelial gastric tumors, such as lipomas, presented here is technically feasible, safe, and less stressful for the patient than gastrectomy. [ABSTRACT FROM AUTHOR]

A 64-year-old Japanese man was diagnosed with a tumor of the stomach. From the findings of an upper gastrointestinal endoscopy, computed tomography scan and endoscopic ultrasonography, the tumor was suggestive of a gastric lipoma. He was successfully treated by an endoscopic unroofing technique. There remained residual tumor just after unroofing, but it disappeared a month later. There remained only a scar and there has been no recurrence. [ABSTRACT FROM AUTHOR]

The article describes the case of a 93-year-old male with haematemesis along with symptoms of lethargy and decreased appetite. Topics discussed include endoscopic haemostasis achieved through injection of adrenalin and application of Haemospray, differential diagnosis, and most common treatment modalities for gastric lipomas.