Anatol J Clin Investig 2009:3(1):50-51 Ersin ÖZTÜRK GATA Haydarpasa Training Hospital, Department of Radiology, İstanbul, Turkey. e-mail: drersini@yahoo.com DUODENAL LIPOMA: COMPUTED TOMOGRAPHY FINDINGS DUODENAL LİPOM: BİLGİSAYARLI TOMOGRAFİ BULGULARI Ersin ÖZTÜRK 1 , Cihan DURAN 2 , Güner SÖNMEZ 1 , Ferhat CÜCE 1 , Hüseyin Onur SILDIROĞLU 1 , Hakan MUTLU 1 , Çınar BAŞEKİM 1 , Eşref KIZILKAYA 1 1 GATA Haydarpasa Training Hospital, Department of Radiology, İstanbul, Turkey. 2 Florence Nightingale Hospital, Department Of Radiology, Istanbul Abstract Lipomas are benign mesenchymal tumors. Although they are common, lipomas consist of 5-6 % of gastrointestinal benign tumors. Computed tomography is the best imaging method for the non-invasive diagnosis of gastrointestinal lipomas. In this article, we present a case of duodenal lipoma which was diagnosed incidentally during an abdominal CT examination performed for right upper quadrant pain and jaundice in a 71-year-old woman. (Anatol J Clin Investig 2009:3(1):50-51). Özet: Lipomlar iyi huylu mezenkimal tümörlerdir. Sık görülmelerine rağmen iyi huylu gastrointestinal tümörlerin yalnızca %5-6’sını oluştururlar. Bilgisayarlı tomografi gastrointestinal lipomların invazif olmayan yollarla saptanmasında en iyi görüntüleme yöntemidir. Bu makalede sağ üst kadran ağrısı ve sarılık şikayetleri nedeniyle çekilen batın bilgisayarlı tomografisinde rastlantısal olarak duodenal lipom saptanan 71 yaşındaki kadın olgu sunulmuştur. (Anatol J Clin Investig 2009:3(1):50-51). Introduction Lipomas are benign mesenchymal tumors. Although they are common, lipomas consist of 5- 6 % of gastrointestinal benign tumors [1]. In gastrointestinal tract, duodenal lipomas are rare, the frequently affected site is large intestine. Computed tomography (CT) has been used for identifing intestinal lipomas successfully because of its ability to discriminate fine differences of tissue density Case report A case of a 71-year-old woman who had right upper quadrant pain, progresive nausea and intermittent episodes of jaundice is presented. In the diagnostic workup, ultrasonography showed multiple cystic lesions in the liver, probable a diagnosis of cyst hydatid was made. Before surgery, contrast enhanced CT revealed multiple cysts of hydatid diasese in the liver and a well- defined submucosal mass with a diameter of 16 mm in the second portion of the duodenum (Figure 1A,1B). The measurement of the attenuation was -90 HU and this submucosal mass with fat attenuation was diagnosed as lipoma Discussion Lipomas are rare benign gastrointestinal system tumors. The most frequently affected sites are large intestine (64%, particularly ascending colon and rectum) and small intestine (26%, particularly ileum). In benign duodenal tumors which included adenoma, leiomyoma, polyps and hemangioma, the frequency of lipoma is 19,6% after adenoma (26%) and leiomyoma (19,8%) (2). The lipomas are benign, slow growing tumors. Malign transformation of a gastrointestinal lipoma has not been reported. They are submucosal located and only 5% are subserosal in origin [1].The tumor becomes pedicled because of the traction force exerted by the intestinal contents and peristaltic movements [2]. The lipomas are generally asymptomatic and the occurrence of symptoms are related to the location and size of the tumor. The lipomas larger than the diameter of 2 cm may produce symptoms such as abdominal discomfort, pain, rectal bleeding and acute abdomen owing to intussusception or obstruction [3]. Most lesions are small and less than 1 cm in size is usually asymptomatic, discovered at CT incidentally [4]. CT has been used to evaluate intramural masses because it is valuable and an ideal technique to discriminate the differences of tissue density and confirm the presence of fatty tissue in a tumor and therefore to diagnose lipomas. Among the intramural lesions of the gastrointestinal system, only lipoma can be diagnosed definitely at CT as a well-demarcated mass with its characteristic fat density [5]. The major problem is to find the