2003 年 63 巻 2 号 p. 90-91
The patient was a 71-year-old female. Although she had been experiencing tarry stools since December 18th, 2002, she had not consulted a doctor. But, considerable exertional dyspnea and dizziness developed and she was admitted to our hospital on December 24th. Gastrointestinal endoscopic findings was a glans-like protruded lesion with an uneven surface accompanied by reddening and ulceration in the anterior wall of the fornix. Biopsies detected no distinct tumor cells, only detecting inflammatory cells. Endoscopic ultrasonography (EUS) showed a clearly bordered high echoic mass of high echo originating from the third layer. Abdominal CT showed a low-absorption region protruding into the gastric cavity. Gastric lipoma was suspected from these findings, the possibility of being any other disease or malignancy could not be denied, the laparoscopic partial gastrectomy was performed. Histopathological examination revealed that the tumor consisted of mature adipose, with partial infiltration from the muscularis mucosae to the lamina propria. Finaly, the lesion was diagnosed as gastric lipoma. Generally, only a few reports are available on pedicled lipoma and in addition, endoscopic findings like this case seems to be rare. Abdominal CT and EUS are useful in the diagnosis of gastric lipoma and less invasive surgery of laparoscopic partial gastrectomy is expected to find further applications in its treatment.