GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEW

Detalhes bibliográficos
Autor(a) principal: Martins, Ruben
Data de Publicação: 2024
Outros Autores: Morais, Henrique
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.34635/rpc.1016
Resumo: Introduction: Gastric lipomas are rare and defined as giant when they are greater than 4 cm, which is exceedingly rare. Most of them are asymptomatic; however, some symptoms may occur due to complications such as ulceration, digestive bleeding, or gastric obstruction. Case report: A 63-year-old male patient presented with early satiety, dyspepsia, and one episode of melena. Investigation revealed a ulcerated polypoid lesion, suggestive of a lipoma, in the antrum measuring approximately 7cm. The patient was discussed in a multidisciplinary meeting, and laparoscopic enucleation was proposed. The surgery and post-operative period were uneventful. Literature review: A total of 40 surgically treated cases of giant gastric lipomas are reported in the literature. The average age at presentation is 55, and the most common symptoms are melena (56%), hematemesis (29%), and epigastric pain (29%). In more than half of the cases, an ulcer is present. On computed tomography, most lesions are well-defined, homogeneous, submucosal, and composed of fat, which is practically pathognomonic. Discussion: This rare condition should be managed by a multidisciplinary team. We recommend endoscopic techniques for lesions up to 4cm and surgical management for larger lesions. Minimally invasive surgery should be preferred, and enucleation should be the standard procedure.
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spelling GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEWLIPOMA GÁSTRICO GIGANTE: CASO CLÍNICO E REVISÃO DA LITERATURAIntroduction: Gastric lipomas are rare and defined as giant when they are greater than 4 cm, which is exceedingly rare. Most of them are asymptomatic; however, some symptoms may occur due to complications such as ulceration, digestive bleeding, or gastric obstruction. Case report: A 63-year-old male patient presented with early satiety, dyspepsia, and one episode of melena. Investigation revealed a ulcerated polypoid lesion, suggestive of a lipoma, in the antrum measuring approximately 7cm. The patient was discussed in a multidisciplinary meeting, and laparoscopic enucleation was proposed. The surgery and post-operative period were uneventful. Literature review: A total of 40 surgically treated cases of giant gastric lipomas are reported in the literature. The average age at presentation is 55, and the most common symptoms are melena (56%), hematemesis (29%), and epigastric pain (29%). In more than half of the cases, an ulcer is present. On computed tomography, most lesions are well-defined, homogeneous, submucosal, and composed of fat, which is practically pathognomonic. Discussion: This rare condition should be managed by a multidisciplinary team. We recommend endoscopic techniques for lesions up to 4cm and surgical management for larger lesions. Minimally invasive surgery should be preferred, and enucleation should be the standard procedure.Introdução: A identificação de um lipoma gástrico é uma situação rara, sendo estas lesões definidas como gigantes quando são maiores que 4 cm, o que é excepcional. A maioria destas lesões é assintomática. No entanto, podem surgir algumas queixas relacionadas com complicações como ulceração, hemorragia digestiva ou obstrução gástrica. Caso clínico: Paciente do sexo masculino, 63 anos, com queixas de saciedade precoce, dispepsia e um episódio de melena. A investigação identificou uma lesão polipóide, ulcerada, no antro gástrico, medindo cerca de 7 cm, sugestiva de lipoma. O paciente foi discutido em reunião multidisciplinar e foi proposta enucleação laparoscópica da lesão. A cirurgia e o pós-operatório decorreram sem intercorrências. Revisão da literatura: Um total de 40 casos de lipomas gástricos gigantes tratados cirurgicamente são relatados na literatura internacional. A idade média de apresentação é 55 anos e os sintomas mais comuns são melenas (56%), hematémese (29%) e dor epigástrica (29%). Em mais da metade dos casos existe uma úlcera associada. Na tomografia computadorizada a maioria das lesões é bem delimitada, homogénea, submucosa e composta por gordura, o que é praticamente patognomónico. Discussão: Esta condição rara deve ser tratada por uma equipa multidisciplinar. Recomendamos técnicas de excisão endoscópica para lesões com um máximo de 4cm e a remoção cirúrgica de lesões maiores. A cirurgia minimamente invasiva deve ser privilegiada, e recomendamos a enucleação como procedimento padrão.Sociedade Portuguesa de Cirurgia2024-01-11info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34635/rpc.1016https://doi.org/10.34635/rpc.1016Revista Portuguesa de Cirurgia; No 56 (2023): December; 57-63Revista Portuguesa de Cirurgia; No 56 (2023): December; 57-632183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://revista.spcir.com/index.php/spcir/article/view/1016https://revista.spcir.com/index.php/spcir/article/view/1016/701Copyright (c) 2024 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessMartins, RubenMorais, Henrique2024-03-14T22:05:31Zoai:revista.spcir.com:article/1016Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T04:00:55.097823Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEW
LIPOMA GÁSTRICO GIGANTE: CASO CLÍNICO E REVISÃO DA LITERATURA
title GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEW
spellingShingle GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEW
Martins, Ruben
title_short GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEW
title_full GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEW
title_fullStr GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEW
title_full_unstemmed GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEW
title_sort GIANT GASTRIC LIPOMA: A CASE REPORT AND LITERATURE REVIEW
author Martins, Ruben
author_facet Martins, Ruben
Morais, Henrique
author_role author
author2 Morais, Henrique
author2_role author
dc.contributor.author.fl_str_mv Martins, Ruben
Morais, Henrique
description Introduction: Gastric lipomas are rare and defined as giant when they are greater than 4 cm, which is exceedingly rare. Most of them are asymptomatic; however, some symptoms may occur due to complications such as ulceration, digestive bleeding, or gastric obstruction. Case report: A 63-year-old male patient presented with early satiety, dyspepsia, and one episode of melena. Investigation revealed a ulcerated polypoid lesion, suggestive of a lipoma, in the antrum measuring approximately 7cm. The patient was discussed in a multidisciplinary meeting, and laparoscopic enucleation was proposed. The surgery and post-operative period were uneventful. Literature review: A total of 40 surgically treated cases of giant gastric lipomas are reported in the literature. The average age at presentation is 55, and the most common symptoms are melena (56%), hematemesis (29%), and epigastric pain (29%). In more than half of the cases, an ulcer is present. On computed tomography, most lesions are well-defined, homogeneous, submucosal, and composed of fat, which is practically pathognomonic. Discussion: This rare condition should be managed by a multidisciplinary team. We recommend endoscopic techniques for lesions up to 4cm and surgical management for larger lesions. Minimally invasive surgery should be preferred, and enucleation should be the standard procedure.
publishDate 2024
dc.date.none.fl_str_mv 2024-01-11
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dc.identifier.uri.fl_str_mv https://doi.org/10.34635/rpc.1016
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://revista.spcir.com/index.php/spcir/article/view/1016
https://revista.spcir.com/index.php/spcir/article/view/1016/701
dc.rights.driver.fl_str_mv Copyright (c) 2024 Revista Portuguesa de Cirurgia
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2024 Revista Portuguesa de Cirurgia
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Cirurgia
publisher.none.fl_str_mv Sociedade Portuguesa de Cirurgia
dc.source.none.fl_str_mv Revista Portuguesa de Cirurgia; No 56 (2023): December; 57-63
Revista Portuguesa de Cirurgia; No 56 (2023): December; 57-63
2183-1165
1646-6918
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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