A giant asymptomatic gastric fibrolipoma characterized by computed tomography and magnetic resonance imaging

A 69-year-old man was hospitalized for elective surgical resection of a huge asymptomatic mass at the gastric antrum. The mass was initially discovered incidentally on routine chest computed tomography (CT) 15 months prior to admission. It was a well-defined, elliptical fat density with internal mixed density measuring 46×84-mm. Follow-up magnetic resonance imaging (MRI) at the time of admission revealed a fat-like signal in the antrum cavity with internal mixed signal and no obvious enhancement measuring 54×110-mm. Gastroscopy revealed a huge submucosal antral mass with intact overlying mucosa and no ulceration or bleeding. A distal gastrectomy was performed. The gross pathological specimen measured 105×65×50-mm, which corresponded more closely to the MRI measurement. Postoperative histopathology revealed that the tumor was located in the submucosal layer and was composed of closely arranged proliferating mature adipocytes.