Diagnosis and treatment of lipomas of the digestive tract (Practical recommendations. Review)

Lipoma is a common benign subepithelial neoplasm of mesenchymal origin that develops slowly from adipose tissue in the gastrointestinal tract. Most lipomas occur in the colon, accounting for 60-75% of cases, with less frequent occurrences in the small intestine, esophagus, and stomach. Diagnosis is typically made through endoscopic examination, while endosonography can provide more specific information. In endosonographic imaging, lipomas appear as homogeneous, hyperechoic masses originating from the submucosa (third layer). If the lipoma grows or becomes malignant, additional tests such as forceps biopsy, step biopsy, or fine needle aspiration under endoscopic ultrasound guidance can be performed for morphological verification. Treatment is recommended if the lipoma causes symptoms like pain, obstruction, or bleeding, or if it exceeds 2 centimeters in size. For asymptomatic lipomas, observation protocols may involve regular endoscopic assessments based on size and location to monitor for any changes.

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