BACKGROUND

Lipomas are rare, slow-growing benign mesenchymal neoplasms composed of mature lipocytes, forming accumulations of fatty tissue in the gastrointestinal tract wall, and can occur in any part of it. Gastric lipomas constitute less than 3% of benign and less than 1% of all gastric neoplasms. Minimally invasive laparoscopic surgery is considered the gold standard for treating large non-epithelial neoplasms of the stomach and duodenum. However, with the active introduction of endoscopic intraluminal operations into everyday practice, new promising solutions to this problem are opening up.

OBJECTIVE

To share our experience of removing a giant gastric and duodenal lipoma using endoscopic submucosal dissection (ESD) based on a clinical case.

CLINICAL CASE

A 53-year-old patient was admitted to the Department of Diagnostic and Therapeutic Endoscopy for further examination and determination of treatment strategy, presenting with complaints of upper abdominal pain, dyspepsia, and vomiting, predominantly after eating and at night. These symptoms were associated with a giant gastric lipoma causing obstruction of the gastric outlet and the duodenum. After consultation with surgeons, the neoplasm was removed using the ESD method in one block, which allowed avoiding resection of the stomach and duodenal bulb. In this case, the lipoma was located in the submucosal layer of the antral region and partially in the duodenal bulb. No complications from the intervention were noted.

CONCLUSION

The presented clinical observation confirms that ESD can be a safe alternative to traditional surgery for the removal of large symptomatic gastric lipomas.