A Case of Gastric Lipoma Presented with Acute Gastrointestinal Hemorrhage and Resected by Laparoscopic Assisted Distal Gastrectomy

Abstract

A 63-year-old man presented with anemia. Upper gastrointestinal endoscopy revealed a gastric submucosal tumor at the posterior wall of gastric antrum, and it was followed up on suspicion of gastric lipoma. Half-year later, he developed tarry stools accompanied by severe anemia (Hb : 5.5g/dl). On emergent upper gastrointestinal endoscopy, hemorrhagic ulcers were seen on the known gastric submucosal tumor, so we stopped the bleeding with thrombin. To deal with the high risk of re-bleeding, laparoscopic assisted distal gastrectomy was performed. On the resected specimens, the tumor was 66 × 45mm in size. Histologically, the tumor was diagnosed as benign lipoma. Gastric lipoma which can be gastric liposarcoma and which is accompanied by bleeding or obstruction are in need of resection. There are a variety of therapeutic approaches and surgical procedures. We need to make a right choice of treatment depending on tumor size and location. Gastric lipoma with bleeding is a rare disease, and this case is discussed with reference to the literature.