PMC5464394_01
Upper endoscopy showing an elevated lesion in the posterior wall of the lower corpus.
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F1
Esophagogastroduodenoscopic observations revealed a whitish, elevated lesion 20 mm in diameter with 4 large lobules and a central depression in the posterior wall of the lower corpus (Figure 1).
EUS image revealing a hypoechoic mass in the mucosal layer without submucosal invasion, and a homogeneous hyperechoic mass in the submucosal layer.
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F2
EUS also revealed a homogeneous hyperechoic mass in the submucosal layer immediately below the gastric tumor, covered completely by the gastric lesion (Figure 2).
During ESD, the lipoma emerged immediately below the gastric cancer.
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F3
During careful ESD, a yellowish mass was found emerging from the submucosa (Figure 3).
Histopatholigical image of the lesion (hematoxylin and eosin, 40x), resected en-bloc, showing the gastric lipoma located immediately beneath the gastric cancer.
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F4
Histopathological analysis revealed a well-differentiated intramucosal adenocarcinoma (20 x 22 mm) and a gastric lipoma 12 mm in diameter (Figure 4).