Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 14, 2017; 23(30): 5619-5633
Published online Aug 14, 2017. doi: 10.3748/wjg.v23.i30.5619
Systematic review of giant gastric lipomas reported since 1980 and report of two new cases in a review of 117110 esophagogastroduodenoscopies
Mitchell S Cappell, Charlton E Stevens, Mitual Amin
Mitchell S Cappell, Department of Gastroenterology and Hepatology, William Beaumont Hospital, Royal Oak, MI 48073, United States
Mitchell S Cappell, Mitual Amin, Oakland University William Beaumont School of Medicine, Royal Oak, MI 48073, United States
Charlton E Stevens, San Antonio Military Medical Center, San Antonio, TX 78219, United States
Mitual Amin, Department of Pathology, William Beaumont Hospital, Royal Oak, MI 48073, United States
Author contributions: Cappell MS and Stevens CE contributed equally to this work; Stevens CE wrote the initial 2 case reports and a skeleton of the results section; Cappell MS, as mentor, initiated this work, edited the 2 case reports, and wrote the bulk of the introduction, methods, results, and discussion sections; Amin M performed all the microscopic and gross pathology, and wrote the pathologic sections of the paper.
Conflict-of-interest statement: None for all authors. In particular, Dr. Cappell, as a consultant of the United States Food and Drug Administration (FDA) Advisory Committee for Gastrointestinal Drugs, affirms that this paper does not discuss any proprietary confidential pharmaceutical data submitted to the FDA. Dr. Cappell is also a member of the speaker’s bureau for AstraZeneca and Daiichi Sankyo, co-marketers of Movantik. This work does not discuss any drug manufactured or marketed by AstraZeneca or Daiichi Sankyo.
Data sharing statement: Consent was not obtained but the presented data are anonymized and the risk of identification is low.
Open-Access: 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/
Correspondence to: Mitchell S Cappell, MD, PhD, Chief, Department of Gastroenterology and Hepatology, William Beaumont Hospital, MOB # 602, 3535 W. Thirteen Mile Rd, Royal Oak, MI 48073, United States. mscappell@yahoo.com
Telephone: +1-248-5511227 Fax: +1-248-5517581
Received: April 6, 2017
Peer-review started: April 11, 2017
First decision: April 17, 2017
Revised: May 4, 2017
Accepted: June 18, 2017
Article in press: June 19, 2017
Published online: August 14, 2017
Processing time: 128 Days and 23.7 Hours
Core Tip

Core tip: Systematic literature review of giant gastric lipomas revealed 32 reported cases since 1980, with 2 new cases reported among 117110 esophagogastroduodenoscopies. Two authors independently reviewed literature, and decided by consensus which articles to incorporate. Average-patient-age = 54.5 ± 17.0 years (males = 68.8%). Mean-maximal-lipoma-diameter = 7.9 cm ± 4.1 cm. Lipoma locations: antrum-17, antrum and other gastric segments-7, other-8. Lipomas were submucosal-92%, subserosal-8%. Presentations included: acute upper gastrointestinal (UGI) bleeding-19, abdominal pain-5, nausea/vomiting-5, asymptomatic-3. Esophagogastroduodenoscopy was extremely helpful diagnostically; findings included: yellowish hue, well-demarcated margins, and smooth overlying mucosa. Endoscopic biopsies were infrequently diagnostic. Twenty of 21 abdominal CTs demonstrated characteristic lipoma findings: well-circumscribed, submucosal, and homogeneous mass with fat attenuation. Endoscopic-ultrasound showed characteristic findings in 80%. All patients underwent successful therapy without major complications/mortality, including: laparotomy-with-full-thickness-gastric-wall-resections-26; and other-6. Two newly reported patients presented with severe UGI bleeding from giant, ulcerated, gastric lipomas. This review may help standardize work-up of these patients.