Kmiecik M, Walczak A, Samborski P, Paszkowski J, Dobrowolska A, Karczewski J, Swora-Cwynar E. Upper gastrointestinal bleeding as an unusual manifestation of localized Ménétrier’s disease with an underlying lipoma: A case report. World J Gastrointest Endosc 2023; 15(1): 10-18 [PMID: 36686066 DOI: 10.4253/wjge.v15.i1.10]
Corresponding Author of This Article
Michal Kmiecik, HSD, Undergraduate Student, Department of Gastroenterology, Nutrition and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, Poznan 60-355, Poland. 83633@student.ump.edu.pl
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/
World J Gastrointest Endosc. Jan 16, 2023; 15(1): 10-18 Published online Jan 16, 2023. doi: 10.4253/wjge.v15.i1.10
Upper gastrointestinal bleeding as an unusual manifestation of localized Ménétrier’s disease with an underlying lipoma: A case report
Michal Kmiecik, Aleksandra Walczak, Pawel Samborski, Jacek Paszkowski, Agnieszka Dobrowolska, Jacek Karczewski, Ewelina Swora-Cwynar
Michal Kmiecik, Pawel Samborski, Agnieszka Dobrowolska, Jacek Karczewski, Ewelina Swora-Cwynar, Department of Gastroenterology, Nutrition and Internal Medicine, Poznan University of Medical Sciences, Poznan 60-355, Poland
Aleksandra Walczak, Department of Clinical Pathology, Poznan University of Medical Sciences, Poznan 60-355, Poland
Jacek Paszkowski, Department of General & Endocrine Surgery, and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan 60-355, Poland
Author contributions: Kmiecik M and Swora-Cwynar E wrote and edited the manuscript; Walczak A performed pathologic examination of the mass, wrote the paragraph on pathologic diagnosis and prepared microscopic figures; Samborski P and Paszkowski J performed endoscopic submucosal dissection and participated in editing the manuscript; Karczewski J and Dobrowolska A reviewed the manuscript.
Informed consent statement: A written informed consent for ESD was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have 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: Michal Kmiecik, HSD, Undergraduate Student, Department of Gastroenterology, Nutrition and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, Poznan 60-355, Poland. 83633@student.ump.edu.pl
Received: October 15, 2022 Peer-review started: October 15, 2022 First decision: October 27, 2022 Revised: November 16, 2022 Accepted: December 5, 2022 Article in press: December 5, 2022 Published online: January 16, 2023 Processing time: 85 Days and 15.4 Hours
Abstract
BACKGROUND
Ménétrier’s disease is a rare condition characterized by enlarged gastric folds, usually located in the whole body and fundus of the stomach. This report presents an unusual case of localized Ménétrier’s disease elevated by a submucosal lipoma and thus looking like a polypoid mass and causing an episode of upper gastrointestinal bleeding. The mass was successfully removed with endoscopic submucosal dissection.
CASE SUMMARY
Esophagogastroduodenoscopy was performed on a 76-year-old male patient after an episode of upper gastrointestinal bleeding, manifesting as fatigue and melena. A large polypoid mass (4 cm × 1 cm) with enlarged mucosal folds was found in the body of the stomach, between the lesser curvature and posterior wall. A small ulcer at the distal end of the mass was identified as the source of the bleeding. Biopsy was negative for neoplasia. Computed tomography showed a submucosal lesion beneath the affected mucosa, most likely a lipoma. The mass was removed en bloc with tunneling endoscopic submucosal dissection. Final pathology determined that the mass included Ménétrier’s disease and a submucosal lipoma. The patient was scheduled for follow-up esophagogastroduodenoscopy.
CONCLUSION
Localized Ménétrier’s disease can coexist with a submucosal lipoma creating a polypoid mass with risk of bleeding.
Core Tip: We report the first case of localized Ménétrier’s disease coexisting with a submucosal lipoma. The elevation of the affected mucosa made it prone to mechanical damage and caused an episode of upper gastrointestinal bleeding. Tunneling endoscopic submucosal dissection proved to be an effective method of resecting such a lesion. Since the remaining mucosa seemed unaffected by the disease, we expect the resection to be curative.
