An unusual case of gastric angiolipoma presenting with upper gastrointestinal bleeding

Abstract

Gastric angiolipomas (GA) are rare benign tumors that can present with gastrointestinal bleeding and anemia. We describe a 73-year-old woman who presented with a 3-day history of fatiguability, epigastric pain and melena. A computed tomography scan revealed a hypodense lesion, measuring 6 × 6 × 5 cm, along the upper part of the stomach. An upper endoscopy revealed a large polypoid lesion, measuring 8 × 6 cm, between the cardia and body of the stomach. Multiple biopsy specimens were taken, and a histopathological examination showed an acute erosive helicobacter-associated reactive gastritis but no definitive atypia. A linear endoscopic ultrasound revealed a large, homogenous, hyperechoic lesion, consistent with a lipoma, in the body of the stomach. A fine needle aspiration was negative for malignancy. A laparoscopy was offered, and a wedge resection was performed. A histopathological examination revealed a well-circumscribed, encapsulated lipomatous tumor in the gastric submucosa with focal mucosal ulceration. The patient had an uneventful postoperative recovery and her hemoglobin level subsequently returned to normal. Overall, clinicians may be unfamiliar with GA because patients may present with signs and symptoms that can be confused with other gastrointestinal conditions. Physicians should be aware of the characteristic histopathological features to distinguish GA from other diseases of the gastrointestinal tract that may share similar clinical or radiologic features.