Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2016; 22(15): 4066-4070
Published online Apr 21, 2016. doi: 10.3748/wjg.v22.i15.4066
Gastric inverted hyperplastic polyp: A rare cause of iron deficiency anemia
Jin Tak Yun, Seung Woo Lee, Dong Pil Kim, Seung Hwa Choi, Seok-Hwan Kim, Jun Kyu Park, Sun Hee Jang, Yun Jung Park, Ye Gyu Sung, Hae Jung Sul
Jin Tak Yun, Seung Woo Lee, Dong Pil Kim, Seung Hwa Choi, Seok-Hwan Kim, Jun Kyu Park, Sun Hee Jang, Yun Jung Park, Ye Gyu Sung, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea
Hae Jung Sul, Department of Pathology, College of Medicine, Daejeon St. Mary`s Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea
Author contributions: Yun JT and Lee SW designed the report; Kim DP, Choi SH and Kim SH collected the patient’s clinical data; Park JK, Jang SH, Park YJ and Sung YG contributed to revising the manuscript; Yun JT and Lee SW wrote the paper; all authors contributed to the manuscript.
Supported by Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Daejeon St. Mary’s Hospital, The Catholic University of Korea.
Institutional review board statement: The case has been discussed with the most senior member of staff in charge of the patient’s care who has given consent for this, and consent was obtained for use of accompanying pathologic images from the consultant pathologist. The study was reviewed and approved by the Daejeon St. Mary`s Hospital of the Catholic University of Korea Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to enrollment.
Conflict-of-interest statement: We declare that we have no financial or personal relationships with other individuals or organizations that would inappropriately influence our work. There is no professional or other personal interest of any nature in any product or service.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Seung Woo Lee, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Daejeon St. Mary’s Hospital, The Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon 301-723, South Korea. leeseungw00@hanmail.net
Telephone: +82-42-2209501 Fax: +82-42-2526808
Received: December 12, 2015
Peer-review started: December 13, 2015
First decision: December 21, 2015
Revised: December 25, 2015
Accepted: January 9, 2016
Article in press: January 11, 2016
Published online: April 21, 2016
Processing time: 112 Days and 21.1 Hours
Abstract

Gastric inverted hyperplastic polyp (IHP) is a rare gastric polyp characterized by the downward growth of hyperplastic mucosal components into the submucosal layer. Macroscopically, a gastric IHP resembles a subepithelial tumor (SET); as a result, accurately diagnosing gastric IHP is difficult. This issue has clinical significance because gastric IHP can be misdiagnosed as SET or as malignant neoplasm In addition, adenocarcinoma can accompany benign gastric IHP. Although in most cases, gastric IHPs are asymptomatic and are found incidentally, these polyps may cause anemia secondary to chronic bleeding. Here, we report one case involving gastric IHP accompanied by chronic iron deficiency anemia that was successfully managed using endoscopic submucosal dissection.

Keywords: Stomach; Hyperplasia; Polyp; Anemia

Core tip: Gastric inverted hyperplastic polyp (IHP) is a rare gastric polyp characterized by the downward growth of hyperplastic mucosal components into the submucosal layer. It is difficult to diagnose accurately without endoscopic resection and pathological investigation because of its inverted grown into the submucosal layer and the paucity of case reports. In most cases, gastric IHPs are asymptomatic and are found incidentally. Rarely, it may manifest as anemia secondary to chronic bleeding and can be ignored by inexperienced endoscopist. Importantly, it is reported to be related with dysplasia and adenocarcinoma. So, en bloc resection using endoscopic submucosal dissection was recommended for diagnosis and treatment.