Zhang FM, Ning LG, Wang JJ, Zhu HT, Feng MB, Chen HT. Invasive inflammatory fibrotic polyp of the duodenum: A case report. World J Gastrointest Surg 2025; 17(8): 107558 [DOI: 10.4240/wjgs.v17.i8.107558]
Corresponding Author of This Article
Hong-Tan Chen, MD, Chief Doctor, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. chenhongtan@zju.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
Fen-Ming Zhang, Long-Gui Ning, Jing-Jie Wang, Hua-Tuo Zhu, Hong-Tan Chen, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Mei-Bao Feng, Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Zhang FM and Ning LG contributed to the data collection and writing; Wang JJ and Zhu HT provided knowledge related to endoscopic ultrasonography and provided assistance in the collection of case data; Feng MB provided the pathological analysis and pathological images; Chen HT contributed to conceptualization and supervision; all authors have read and approved the final version to be published.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Tan Chen, MD, Chief Doctor, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. chenhongtan@zju.edu.cn
Received: March 26, 2025 Revised: April 23, 2025 Accepted: June 23, 2025 Published online: August 27, 2025 Processing time: 153 Days and 0.6 Hours
Abstract
BACKGROUND
An inflammatory fibrotic polyp (IFP) of the gastrointestinal tract is generally considered benign and noninvasive. An IFP in the duodenum is very rare. Here we report the case of an aggressive and infiltrative duodenal IFP resembling a malignancy and the patient subsequently underwent surgery. To the best of our knowledge, this is the first case of duodenal IFP invading the subserosa.
CASE SUMMARY
A 50-year-old female patient presented with recurrent epigastric pain for more than 1 month. Gastroscopy revealed a mass in the duodenal bulb involving the pylorus. Endoscopic ultrasound suggested that the lesion was a hypoechoic mass involving the muscularis propria, and duodenal bulb stromal tumor was considered based on abdominal computed tomography and gastric magnetic resonance imaging findings. A distal gastrectomy was subsequently performed. Based on the histopathology and immunohistochemical results, the lesion was finally diagnosed as duodenal IFP. The patient recovered well after surgery and had no recurrence at the 27-month follow-up.
CONCLUSION
This duodenal IFP invading subserosa indicates that IFP has specific invasion characteristics, and accurate diagnosis is critical to avoid inadequate treatment.
Core Tip: An inflammatory fibrotic polyp (IFP) of the gastrointestinal tract is generally considered benign and noninvasive. An IFP in the duodenum is very rare. Here we report the case of a mass in the duodenal bulb involving the pylorus. Based on imaging and endoscopic findings, a duodenal stromal tumor was considered. The patient underwent surgery, with a pathologic diagnosis of duodenal IFP and tumor invasion of the subserosa, which indicated that IFP is also specifically invasive. Due to the special location of duodenal IFP, accurate diagnosis should be made so as to avoid excessive surgical treatment.
