Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2022; 28(34): 5086-5092
Published online Sep 14, 2022. doi: 10.3748/wjg.v28.i34.5086
Spontaneous expulsion of a duodenal lipoma after endoscopic biopsy: A case report
Zhi-Hao Chen, Li-Hong Lv, Wen-Sheng Pan, Yi-Miao Zhu
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 by the 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:
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.
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

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.


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.


Deep biopsy could lead to spontaneous GI lipoma expulsion. This might be the first step in lipoma diagnosis and treatment.

Keywords: Lipoma, Duodenal neoplasms, Spontaneous expulsion, Endoscopic biopsy, Adipose tissue, Case report

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.