Chen ZH, Lv LH, Pan WS, Zhu YM. Spontaneous expulsion of a duodenal lipoma after endoscopic biopsy: A case report. World J Gastroenterol 2022; 28(34): 5086-5092 [PMID: 36160650 DOI: 10.3748/wjg.v28.i34.5086]
Corresponding Author of This Article
Yi-Miao Zhu, MM, Doctor, Department of Gastroenterology, Zhejiang Provincial People’s Hospital, No. 158 Shangtang Road, Gongshu District, Hangzhou 310014, Zhejiang Province, China. zhuyimiao01@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zhi-Hao Chen, Wen-Sheng Pan, Yi-Miao Zhu, Department of Gastroenterology, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Zhi-Hao Chen, Wen-Sheng Pan, Yi-Miao Zhu, Affiliated Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Li-Hong Lv, Department of Gastroenterology, Xianju County People’s Hospital, Taizhou 317300, Zhejiang Province, China
Author contributions: Chen ZH, Lv LH, and Zhu YM assembled, analyzed, and interpreted the patient’s data and case presentation; Zhu YM and Pan WS reviewed the literature; Chen ZH and Zhu YM prepared the original manuscript; Zhu YM edited and critically revised the manuscript; all authors contributed to writing the manuscript; and all authors read and approved the final manuscript.
Supported bythe Medical Technology and Education of Zhejiang Province of China, No. Y202146136.
Informed consent statement: Written informed consent was obtained from the patient’s guardian for the publication of this case report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Miao Zhu, MM, Doctor, Department of Gastroenterology, Zhejiang Provincial People’s Hospital, No. 158 Shangtang Road, Gongshu District, Hangzhou 310014, Zhejiang Province, China. zhuyimiao01@163.com
Received: March 3, 2022 Peer-review started: March 3, 2022 First decision: June 11, 2022 Revised: July 24, 2022 Accepted: August 21, 2022 Article in press: August 21, 2022 Published online: September 14, 2022 Processing time: 187 Days and 18 Hours
Abstract
BACKGROUND
Gastrointestinal (GI) lipomas are benign submucosal tumors of mature adipocytes that arise mainly in the colon and stomach, sometimes in the ileum and jejunum, and rarely in the duodenum. Patients with symptomatic lipomas require endoscopic or surgical treatment. Spontaneous expulsion of lipomas after biopsy is a rare condition that has limited case reports.
CASE SUMMARY
A 56-year-old man presented to our hospital with intermittent postprandial epigastric fullness. Esophagogastroduodenoscopy (EGD) revealed a 10-mm soft yellowish submucosal lesion with the “pillow sign,” located in the second portion of duodenum. Endoscopic ultrasonography (EUS) using a 12-MHz catheter probe showed a hyperechoic, homogenous, and round solid lesion (OLYMPUS EUS EU-ME2, UM-DP12-25R, 12-MHz radial miniprobe, Olympus Corporation, Tokyo, Japan). Deep biopsy was performed using the bite-on-bite technique with forceps. Histological examination was compatible with submucosal lipoma. The lesion spontaneously expelled 12 d after the biopsy. Follow-up EUS performed after 2 mo confirmed this condition.
CONCLUSION
Deep biopsy could lead to spontaneous GI lipoma expulsion. This might be the first step in lipoma diagnosis and treatment.
Core Tip: Gastrointestinal lipomas are benign tumors consisting of mature adipocytes. Symptomatic patients may require endoscopic or surgical treatment. Here, we report a case of duodenal papillary lipoma, which was spontaneously expelled 12 d after a bite-on-bite deep biopsy with forceps. The spontaneous expulsion of the lipoma shows the possibility of performing a deep biopsy as a fenestration in the first step as a diagnostic and therapeutic procedure.
