BACKGROUND Gastric hamartomatous inverted polyps(GHIPs)are benign polyps of the gastric submucosal layer.Currently there are 52 reported cases in the English literature.According to a literature review,approximately 2...BACKGROUND Gastric hamartomatous inverted polyps(GHIPs)are benign polyps of the gastric submucosal layer.Currently there are 52 reported cases in the English literature.According to a literature review,approximately 27%of GHIPs show a coexisting carcinoma.CASE SUMMARY A 66-year-old man was referred to our institution with ulcerative lesions detected on esophagogastroduodenoscopy(EGD)during a regular check-up.Other medical findings were nonspecific.The lesions had borderline histologic features that could not exclude malignancy and were followed up with three EGDs and biopsies at intervals of 3 mo.The latest biopsy was revealed as an adenocarcinoma.A total gastrectomy was performed to remove the tumor.The surgical specimen revealed a 6.9 cm×4.5 cm sized GHIP with a coexisting 1.6 cm sized well-differentiated adenocarcinoma which extended to the muscularis propria.The malignancy did not originate from the GHIP but showed an overlap.CONCLUSION A large GHIP,which was unusually presented as an ulcerative lesion,was surgically removed,and was accompanied by advanced gastric cancer.Regular follow-up and thorough examinations of ulcerative lesions with equivocal biopsy have resulted in appropriate diagnosis and treatment.Therefore,aggressive intervention may be beneficial if GHIP is suspected.展开更多
基金Supported by Seoul St.Mary’s Hospital,The Catholic University of Korea,No.ZC22TISI0753。
文摘BACKGROUND Gastric hamartomatous inverted polyps(GHIPs)are benign polyps of the gastric submucosal layer.Currently there are 52 reported cases in the English literature.According to a literature review,approximately 27%of GHIPs show a coexisting carcinoma.CASE SUMMARY A 66-year-old man was referred to our institution with ulcerative lesions detected on esophagogastroduodenoscopy(EGD)during a regular check-up.Other medical findings were nonspecific.The lesions had borderline histologic features that could not exclude malignancy and were followed up with three EGDs and biopsies at intervals of 3 mo.The latest biopsy was revealed as an adenocarcinoma.A total gastrectomy was performed to remove the tumor.The surgical specimen revealed a 6.9 cm×4.5 cm sized GHIP with a coexisting 1.6 cm sized well-differentiated adenocarcinoma which extended to the muscularis propria.The malignancy did not originate from the GHIP but showed an overlap.CONCLUSION A large GHIP,which was unusually presented as an ulcerative lesion,was surgically removed,and was accompanied by advanced gastric cancer.Regular follow-up and thorough examinations of ulcerative lesions with equivocal biopsy have resulted in appropriate diagnosis and treatment.Therefore,aggressive intervention may be beneficial if GHIP is suspected.
