Fact-sheet: Lipoma - gastrointestinal


Updated on 05/26/2025 at 8:52 AM

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Definition

Benign tumor composed of mature fat located within the digestive wall.

In decreasing order of frequency, lipomas of the digestive tract are found as follows: Colon > duodenum > ileum > stomach > esophagus.

Clinical features

  • Most often asymptomatic, incidental finding.
  • Rare cases of intussusception with small bowel lipomas.
  • Epigastric fullness with gastric lipomas.
  • Obstructive syndrome
  • Gastrointestinal bleeding in cases of erosion

Laboratory findings

Pathology:

Macroscopically: well-defined, soft, yellowish submucosal lesion.

Microscopically: lobulated proliferation of mature adipocytes, without atypia or mitosis, without necrosis or inflammatory changes.

CT

  • Well-defined, submucosal lesion (95%), hypodense with fat density <= -100HU, nearly pathognomonic.
  • No enhancement after injection.
  • No wall infiltration.

MRI

  • Well-defined lesion, spherical or ovoid,
  • Intramural location not crossing the outer wall of the digestive tract
  • Marked T1 hyperintensity
  • Relative T2 hyperintensity
  • Signal drop-out on T1 FatSat.
  • No enhancement after injection.
  • Possible thin fibrous capsule.

Management

Surgical treatment if symptomatic.

Differential diagnosis

Lipomatosis: diffuse submucosal fat infiltration with well-enhanced mucosa and muscularis, seen in IBD or after chemotherapy.

Gastric lipomatosis

Angiolipoma: Rare. Fat content with a vascular component showing marked enhancement after injection.

Liposarcoma: Large exophytic tumor with fat content, resembling malignant GISTs.