Giant gastric lipoma as an uncommon cause of upper gastrointestinal bleeding

A 52-year-old male patient presented to the Emergency Room due to melena. A gastroscopy was performed, which revealed a submucosal lesion in the antrum of the stomach. The lesion was lined with regular smooth mucosa except for an apical ulceration. Histology showed gastric mucosa with foveolar hyperplasia. Abdominal computed tomography (CT) showed a homogeneous, well-delimited fat-density mass measuring 5.9 x 4.3 cm. Laparoscopic surgery then found a solid tumor involving the whole thickness of the anterior wall at the prepyloric area, which was resected. Microscopic examination revealed a homogeneous, soft, ulcerated submucosal mass of yellowish adipose tissue that was 5 x 5 x 2 cm in size. Microscopically, the tumor was composed of mature fatty tissue with fibrous septa, and was partially encapsulated and circumscribed. It was reported as a submucosal lipoma. The patient had a favorable outcome.