Gastric lipomas are a location-specific subtype of gastrointestinal lipomas and represent a rare benign mesenchymal tumors of the stomach. They can be definitively diagnosed on CT.
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Epidemiology
Gastric lipomas are rare, accounting for <5% of gastrointestinal lipomas and <1% of all gastric neoplasms 2.
Clinical presentation
Patients may present with pain, upper gastrointestinal bleeding, dyspepsia and/or gastric outlet obstruction, although they are typically asymptomatic when small.
Pathology
Gastric lipomas are typically sessile in morphology, solitary (75%) and most frequently located in the gastric antrum. They tend to be submucosal rather than subserosal. Gastric ulceration is common.
Histology
Gastric lipomas are composed of mature adipose cells surrounded by a fibrous capsule.
Radiographic features
Fluoroscopy
Features are non-specific on upper gastrointestinal contrast studies with filling defects and a central bulls-eye, reflecting ulceration common 2,3.
CT
Gastric lipomas present as well-defined, homogeneous fat-density lesions (-70 to -120 is diagnostic) 2.
Differential diagnosis
- on fluoroscopic studies, GIST should always be considered 4
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