Endoscopic Enucleation of a Gastric Lipoma by Strip Biopsy

Lee, Moon Sung; Park, Chan Wook; Kim, Jin Hong; Cho, Sung Won; Shim, Chan Sup

Abstract

Gastric lipomas are rare benign submucosal tumors which can present the diagnostic and therapeutic problems. The preferred treattment is observation or local excision. Since preoperative diagnosis and differentation from malignant tumors can be difficult by use of the conventional diagnostic modalities such as X-ray or endoscopic examination, patients are sometimes subjected to more extensive surgical procedures than warranted. As to the diagnosis of submucosal tumors of the upper digestive tract, a newly developed diagnostic modality of endoscopic ultrasonography(EUS) allows us to visuialize the structures underlying the gastrointestinal wall in a noninvasive maneuver, and can contribute to make differential diagnosis and decision of management. Strip biopsy is an endascopic tissue resection technique which permits resection of both mucosal and submucosal tissue regardless of the morphological type of the lesion, because the submucosal saline injections during the procedures make the flat or depressed lesions to be elevated. Now, we report a 56-yr-old female which had a Yamada type I polypoid gastric submucosal lipoma in the antrum, which could be performed the different diagnosis and successful endoscopic removal by endoscopic ultrasonography and strip biopsy.