Clin Endosc.  2021 May;54(3):432-435. 10.5946/ce.2020.146.

Gastric Angiolipoma Resected with Endoscopic Submucosal Dissection

• Yeo SM
• Lee JK
• Kim HS
• Park CG
• Jung JK
• Kim DJ
• Chung YJ
• Ryu HJ

• KMID: 2516325
• DOI: http://doi.org/10.5946/ce.2020.146

Abstract

Angiolipoma is a benign fatty neoplasm that has components of proliferating blood vessels. These types of lesions commonly occur in the subcutaneous tissue of the limbs and trunk. Angiolipoma in the gastrointestinal tract is extremely rare, and the final diagnosis generally depends on histological examination of the excised biopsy. In most previously reported cases, the lesions were diagnosed and treated with surgical management. In this study, we report a case of gastric angiolipoma of approximately 4 cm in size that was diagnosed and treated with endoscopic submucosal dissection.

Keyword

Angiolipoma; Endoscopic submucosal dissection; Endoscopic ultrasound; Gastric angiolipoma

Figure

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  Fig. 1. Esophagogastroduodenoscopy showing a large subepithelial lesion of approximately 4 cm in size at the lesser curvature of the lower body of the stomach.

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  Fig. 2. Endoscopic ultrasound (EUS) shows a heterogeneous oval lesion, approximately 4 cm in size, originating from the third layer. According to the EUS probe’s location, (A) the echogenicity of the lesion changes from hyperechoic, (B) to isoechoic, and (C) to hypoechoic in appearance.

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  Fig. 3. (A) Marking and (B) dissection using a dual knife is performed, and (C) the entire tumor is successfully removed.

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  Fig. 4. (A) The resected specimen is a subepithelial tumor measuring 3.9 ×1.6 cm. The resection margin is clear. (B) The histopathological examination reveals a tumor in the submucosa, composed of mature adipose tissue interspersed with capillaries (hematoxylin and eosin [H&E], magnification, ×20) and (C) the lesion shows prominent vascular components consisting of numerous small dilated capillaries (H&E, magnification, ×40).

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