Duodenal angiolipoma. An extremely rare cause of upper GI haemorrhage
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214 Hellenic Journal of Surgery 2011; 83: 4
Duodenal Angiolipoma. Αn Extremely Rare Cause of Upper GI Haemorrhage Case Report and Review of the Literature Ch. Kontovounisios, M. Korontzi, Ch. Poullou, Ch. Karaliotas, C. Zacharioudakis, P. Zafeiriadou, S. Lanitis, G. Sgourakis, C. Barbatis, C. Karaliotas Received 29/03/2010 Accepted 05/05/2011
Abstract Background-Aim: Gastrointestinal angiolipomas are rare benign lipomatous lesions first described by Bowen in 1912 and differentiated histologically by Howard in 1960. Duodenal angiolipomas represent a rare pathological condition that can lead to severe gastrointestinal bleeding; they may be treated successfully surgically and occasionally endoscopically. We report the 3rd case of duodenal angiolipoma to be reported in the literature between 1964 and 2010. Method: Databases from Pubmed and Medline were searched using a list of keywords such as angiolipomas, gastrointestinal bleeding, duodenal angiolipomas and references from review articles. Results: 21 reported cases of gastrointestinal angiolipomas have been reported, including 1 case of the oesophagus, 3 of the stomach, 2 of the duodenum, 7 of the small intestine, 2 of the caecum, 4 of the large intestine and 2 cases of the rectum. Conclusion: It is important to include the presence of angiolipomas in the differential diagnosis of gastrointestinal bleeding. These benign lesions may lead to severe bleeding. Careful evaluation and preoperative work up of the patient will determine the treatment of choice and reduce postoperative complications.
Key words
Angiolipomas, Gastrointestinal tract, Duodenum, Upper Gastrointestinal bleeding
Ch. Kontovounisios (Corresponding author) M. Korontzi, C. Zacharioudakis, P. Zafeiriadou, S. Lanitis, G. Sgourakis, C. Karaliotas - 2nd Surgical Department and Surgical Oncology Unit of “Korgialenio-Mpenakio”, Red Cross Hospital, Athens, Greece. Ch. Poullou, C. Barbatis - Pathology Department of “Korgialenio-Mpenakio”, Red Cross Hospital, Athens, Greece Ch. Karaliotas - Reumatology and Rehabilitation Department, VFN University Hospital, Prague, Czech Republic e-mail: [email protected]
Introduction Angiolipoma is a benign subcutaneous tissue neoplasm that contains an unusually large number, or foci, of proliferated, neoplastic-like, frequently dilated vascular channels. It represents 5% - 7% of lipomas [1,2, 3] . Generally located in the upper and lower limbs, trunk and central nervous system, it is rarely seen in the gastrointestinal tract. Those in the gastrointestinal tract present as a submucosal solitary sessile or endoluminal polypoid lesion. With just two cases reported in the international literature during the last 46 years, a duodenal location is extremely rare. We present a case of duodenal angiolipoma with a brief review of the current literature for gastrointestinal angiolipomas based on the databases of Pubmed and Medline, from between 1964 and 2010.
Case Report A 64-year-old woman presented to our hospital’s outpatient department with signs of upper gastrointes
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