A Hemorrhagic Gastric Lipoma Removed Locally by Laparoscopic-Endoscopic Cooperative Surgery—A Case Report—

Abstract

A 78-year-old woman was found to have a submucosal tumor in the posterior wall of the greater curvature of the upper gastric corpus in December 2018. Investigations showed that this was a gastric lipoma, and a policy of watchful waiting was adopted. In July 2022, she presented at a local clinic with palpitations and lightheadedness. She was found to be anemic, with a Hb of 4.1 g/dl, and she was referred to our hospital. Emergency upper gastrointestinal endoscopy showed a submucosal tumor with an apical mucosal defect exposing the lipoma, and blood residue was present in the stomach. Although hemostasis had occurred spontaneously, the lipoma's diameter had enlarged to 65 mm, and because of the risk of rebleeding, classical laparoscopic-endoscopic cooperative surgery (LECS) was performed. The diagnosis on histopathological examination was gastric lipoma. Watchful waiting is the usual strategy for gastric lipoma, but resection is necessary should symptoms such as bleeding or obstruction occur, or if there are signs suggestive of malignancy, and the resection method must take into account tumor diameter and location. Use of classical LECS to remove a hemorrhagic gastric lipoma is reported.