A Case of Giant Gastric Lipoma Incarcerated into Duodenum with Protein-losing Gastroenteropathy

Kiyonori Kanemitsu, Kentaro Kawasaki, Sachiyo Shirakawa, Shiro Takase, Tetsu Nakamura, Takashi Kamigaki, Takashi Yasuda, Takao Ichihara*, Daisuke Kuroda and Yoshikazu Kuroda

Division of Gastroenterological Surgery, Department of Clinical Molecular Medicine, Graduate School of Medical Sciences, Kobe University
Division of Surgery, Kobe Kaisei Hospital*

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 α 1-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 65×45×35 mm 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.

Key words
gastric lipoma, duodenal impaction, protein-losing gastroenteropathy

Reprint requests
Kiyonori Kanemitsu Division of Gastroenterological Surgery, Graduate School of Medical Sciences, Kobe University
7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 JAPAN

Accepted
October 25, 2006

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