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Giant gastric lipoma mimicking well-differentiated liposarcoma.

Hamdane MM, Brahim EB, Salah MB, Haouas N, Bouhafa A, Chedly-Debbiche A - Gastroenterol Hepatol Bed Bench (2012)

Bottom Line: Nuclei were sometimes large, irregular, neither with hyperchromasia nor mitosis.Diagnosis of a well-differentiated liposarcoma was suspected and molecular cytogenetic analyses showed neither MDM2 nor CDK4 gene amplification on fluorescent in situ hybridization.In conclusion, Differentiating benign from malignant fatty tumors is sometimes difficult in morphologic features.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Habib Thameur Hospital, Montfleury, Tunis, Tunisia.

ABSTRACT
Gastric lipoma is a rare tumor, accounting for only 5% of gastrointestinal tract lipomas and less than 1% of all gastric tumors. Histological diagnosis is usually easy. However, the tumor may sometimes undergo significant inflammatory changes leading to a difficult differential diagnosis with well-differentiated liposarcoma. Authors report the case of a 51-year-old man, presenting with epigastralgia of recent onset. Physical exam was unremarkable. Endoscopy revealed a large, ulcerated, submucosal, and antral tumor. CT scan showed an antral mass with fat attenuation. The patient underwent a total gastrectomy. Macroscopic examination identified in the antral wall a 9-cm, well-circumscribed, nodular lesion, with a greasy cut surface. On histological examination, the tumor was composed of a mature adipocytes proliferation, showing significant variation in cell size, associated to some lipoblasts. Nuclei were sometimes large, irregular, neither with hyperchromasia nor mitosis. Diagnosis of a well-differentiated liposarcoma was suspected and molecular cytogenetic analyses showed neither MDM2 nor CDK4 gene amplification on fluorescent in situ hybridization. The diagnosis of lipoma was made. Twelve months after surgery, the patient is doing well. In conclusion, Differentiating benign from malignant fatty tumors is sometimes difficult in morphologic features. In these cases, cytogenetic procedures are the only means for an accurate diagnosis.

No MeSH data available.


Related in: MedlinePlus

Abdominal CT scan: A large, low-attenuation gastric mass
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Figure 0001: Abdominal CT scan: A large, low-attenuation gastric mass

Mentions: A 51-year-old man, in otherwise excellent general health, presented with epigastralgia of recent onset. The patient denied any history of gastrointestinal hemorrhage, nausea, vomiting, change in bowel habits, fevers, or melena. Physical examination was unremarkable. Endoscopy revealed a soft, large, ulcerated, submucosal mass in the gastric antrum. Multiple biopsies were obtained but were all superficial, showing unspecific inflammation of the gastric mucosa. The abdominal CT scan revealed a round, well circumscribed, low-attenuation, gastric antral mass, measuring approximately 9 cm in diameter (Figure 1). Endoscopic ultrasound examinations (EUS) had not been performed. The patient underwent total gastrectomy.


Giant gastric lipoma mimicking well-differentiated liposarcoma.

Hamdane MM, Brahim EB, Salah MB, Haouas N, Bouhafa A, Chedly-Debbiche A - Gastroenterol Hepatol Bed Bench (2012)

Abdominal CT scan: A large, low-attenuation gastric mass
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4017444&req=5

Figure 0001: Abdominal CT scan: A large, low-attenuation gastric mass
Mentions: A 51-year-old man, in otherwise excellent general health, presented with epigastralgia of recent onset. The patient denied any history of gastrointestinal hemorrhage, nausea, vomiting, change in bowel habits, fevers, or melena. Physical examination was unremarkable. Endoscopy revealed a soft, large, ulcerated, submucosal mass in the gastric antrum. Multiple biopsies were obtained but were all superficial, showing unspecific inflammation of the gastric mucosa. The abdominal CT scan revealed a round, well circumscribed, low-attenuation, gastric antral mass, measuring approximately 9 cm in diameter (Figure 1). Endoscopic ultrasound examinations (EUS) had not been performed. The patient underwent total gastrectomy.

Bottom Line: Nuclei were sometimes large, irregular, neither with hyperchromasia nor mitosis.Diagnosis of a well-differentiated liposarcoma was suspected and molecular cytogenetic analyses showed neither MDM2 nor CDK4 gene amplification on fluorescent in situ hybridization.In conclusion, Differentiating benign from malignant fatty tumors is sometimes difficult in morphologic features.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Habib Thameur Hospital, Montfleury, Tunis, Tunisia.

ABSTRACT
Gastric lipoma is a rare tumor, accounting for only 5% of gastrointestinal tract lipomas and less than 1% of all gastric tumors. Histological diagnosis is usually easy. However, the tumor may sometimes undergo significant inflammatory changes leading to a difficult differential diagnosis with well-differentiated liposarcoma. Authors report the case of a 51-year-old man, presenting with epigastralgia of recent onset. Physical exam was unremarkable. Endoscopy revealed a large, ulcerated, submucosal, and antral tumor. CT scan showed an antral mass with fat attenuation. The patient underwent a total gastrectomy. Macroscopic examination identified in the antral wall a 9-cm, well-circumscribed, nodular lesion, with a greasy cut surface. On histological examination, the tumor was composed of a mature adipocytes proliferation, showing significant variation in cell size, associated to some lipoblasts. Nuclei were sometimes large, irregular, neither with hyperchromasia nor mitosis. Diagnosis of a well-differentiated liposarcoma was suspected and molecular cytogenetic analyses showed neither MDM2 nor CDK4 gene amplification on fluorescent in situ hybridization. The diagnosis of lipoma was made. Twelve months after surgery, the patient is doing well. In conclusion, Differentiating benign from malignant fatty tumors is sometimes difficult in morphologic features. In these cases, cytogenetic procedures are the only means for an accurate diagnosis.

No MeSH data available.


Related in: MedlinePlus