Introduction: Gastric lipoma is an uncommon benign tumour of the stomach originating from adipose tissue. The most common location is the pyloric antrum and about 90–95% of cases arise in the submucosal layer. It is usually asymptomatic and is often detected incidentally during endoscopy or imaging examinations.

Case description: We present a case of 53-year-old man presented with five days of melena and severe anaemia (Hb 6.5 g/dL). Contrast- Enhanced Computerized Tomography (CECT) revealed a well-defined fat-attenuation submucosal/subserosal gastric lesion in the distal body/antrum, suggestive of a lipomatous tumour, with possible mucosal ulceration. Upper gastrointestinal endoscopy showed a large submucosal polypoidal lesion with normal overlying mucosa and central ulceration, initially suspected to be a gastrointestinal stromal tumour (GIST). Partial gastrectomy specimen revealed a large submucosal polypoidal lesion with a greasy yellow cut surface, and on histopathology examination final diagnosis was gastric submucosal lipoma with surface ulceration

Discussion: Gastric lipomas are benign tumors that may present with abdominal pain, gastrointestinal bleeding, or obstruction. Diagnosis is based on imaging and endoscopic evaluation, although biopsy is often inconclusive because of their submucosal location. Surgical removal is the preferred treatment for symptomatic or large lipomas. Definitive diagnosis can be established through histopathological examination of the surgically resected specimen.

Conclusion: Although gastric lipomas are rare, they can be difficult to diagnose, particularly when they present with bleeding. Asymptomatic lesions may be managed conservatively with observation and surgical resection is the mainstay of treatment for symptomatic or large lipomas.