2026-10-14T12:40:54Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33981637 2026-09-29T11:54:03Z category_7 portal_147 item_type_3 month_year_09_2026

Supplemental Material for: Ulcerated Lipoma as a Hidden Culprit in Iron-Deficiency Anemia: A Case Report figshare admin karger (2628495) Mariana Souto (10481387) Vítor Macedo Silva (25103714) Bruno Rosa (11988371) José Cotter (11988380) Medicine Medicine <p dir="ltr">A 62-year-old man with hypertension was referred for iron-deficiency anemia (hemoglobin, 11.5 g/dL; ferritin, 9.7 ng/mL; transferrin saturation, 7.6%). No visible blood loss or abdominal symptoms were reported. Esophagogastroduodenoscopy showed a yellowish antral subepithelial lesion and two duodenal subepithelial lesions, consistent with lipomas. Colonoscopy revealed multiple yellowish subepithelial lesions compatible with lipomas, the largest nearly occluding the sigmoid lumen. However, those findings did not fully explain the iron-deficiency anemia. Abdominal computed tomography showed multiple fat-density lesions of the digestive tract extending from the stomach to the descending colon. Small bowel capsule endoscopy (SBCE) was therefore performed to investigate potential sources of small bowel bleeding. It demonstrated multiple yellowish subepithelial lesions throughout the small bowel and a jejunal large lesion with luminal bulging, edematous mucosa, and superficial ulceration (shown in Fig. 1A, B). Because the ulcerated proximal lesion was considered a probable source of chronic occult blood loss, antegrade single-balloon enteroscopy was performed. At 60 cm beyond the pylorus, a 40 mm semipedunculated, congestive, superficially ulcerated lesion was identified (shown in Fig. 1C, D). Although ulceration in a large small-bowel subepithelial lesion may raise concern for other neoplasms, including gastrointestinal stromal tumor, neuroendocrine tumor, or small-bowel adenocarcinoma, the multifocal fat-density lesions on computed tomography and the typical yellowish, soft-appearing endoscopic morphology strongly favored gastrointestinal lipomatosis. Given the semipedunculated morphology, endoscopic accessibility, and suspected role as the bleeding source, endoscopic resection was preferred over surgery, as it offered a minimally invasive approach with potential for definitive treatment and histological confirmation. After submucosal injection with gelatin solution, methylene blue, and diluted epinephrine, it was removed with a diathermic snare; the mucosal defect was closed with five through-the-scope clips (shown in Fig. 1E, F). Histology confirmed a submucosal lipoma with focal erosion/ulceration. Oral iron supplementation was prescribed after endoscopic treatment, according to standard care. At 6 months, no overt bleeding or recurrent anemia was observed, and hemoglobin had normalized to 15.6 g/dL.</p> 2026-09-29T11:54:03Z Dataset Dataset 10.6084/m9.figshare.33981637.v1 https://figshare.com/articles/dataset/Supplemental_Material_for_Ulcerated_Lipoma_as_a_Hidden_Culprit_in_Iron-Deficiency_Anemia_A_Case_Report/33981637 CC BY 4.0