Giant symptomatic gastric lipoma: a case report
Published in the International Journal of Surgery Case Reports, the authors present a case of a giant gastric lipoma that became symptomatic seven years after its initial identification and was excised preserving gastric continuity.

A 58-year-old 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 x 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.

• Gastric lipomas may become symptomatic when they reach a size ≥ 10 cm in greatest dimension, at which point they are classified as giant gastric lipomas.

• Gastric lipomas are benign lesions that have a density similar to peripheral fat density on CT scanning, −80 to −120 Houndfield units, a finding which is nearly pathognomonic.

• Circumferential excision of gastric lipomas with a clear margin of normal tissue is adequate for symptomatic resection and through preservation of gastric continuity via gastrotomy and primary closure, complications associated with gastrojejunostomy are avoided.

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