2007 Volume 40 Issue 5 Pages 559-564
We report a rare case of giant gastric lipoma with protein-losing gastroenteropathy and incarcerating into the duodenum. A 34-year-old man with bloody vomit and epigastric pain was found in gastrointestinal fiberscopy in 2002 to have a submucosal tumor with an ulcer at the gastric antrum. These symptoms were treated successfully by medication without additional treatment. In December 2004, he was seen for epigastric pain and abdominal fullness, gastrointestinal fiberscopy showed growth and impaction of a gastric tumor into the duodenum. Abdominal computed tomography and magnetic resonance imaging showed the tumor to be lipoma. Severe hypoproteinemia and high α1-antitripsin clearance were observed and protein-losing from the tumor was observed in abdominal scintigraphy with 99mTc-DTPA-HSA. Based on a diagnosis of a gastric lipoma incarcerated into the duodenum with protein-losing gastroenteropathy, we resected the 65×45×35mm tumor with laparoscopic assistance. The tumor was wide-based at the antrum and pathologically diagnoses as lipoma. The patient recovered without complications, and no hypoproteinemia or high α1-antitripsin was not observed a month after surgery.
