Park G, Kim J, Lee SH, Kim Y. Large gastric hamartomatous inverted polyp accompanied by advanced gastric cancer: A case report. World J Clin Cases 2023; 11(28): 6967-6973 [PMID: 37901034 DOI: 10.12998/wjcc.v11.i28.6967]
Corresponding Author of This Article
Younghoon Kim, MD, PhD, Assistant Professor, Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, No. 222 Banpo-daero, Seocho-gu, Seoul 06591, South Korea. sellar1@snu.ac.kr
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/
World J Clin Cases. Oct 6, 2023; 11(28): 6967-6973 Published online Oct 6, 2023. doi: 10.12998/wjcc.v11.i28.6967
Large gastric hamartomatous inverted polyp accompanied by advanced gastric cancer: A case report
Gyerim Park, Jihye Kim, Sung Hak Lee, Younghoon Kim
Gyerim Park, Sung Hak Lee, Younghoon Kim, Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
Jihye Kim, Department of Internal Medicine, CHA Gangnam Medical Center, CHA University, Seoul 06135, South Korea
Jihye Kim, Center for Health Promotion and Optimal Aging, Seoul National University Hospital, Seoul 03080, South Korea
Author contributions: Park G and Kim Y drafted the article; Park G and Kim J contributed to the data collection; Lee SH and Kim Y edited the article; all authors read and approved the final article.
Supported bySeoul St. Mary’s Hospital, The Catholic University of Korea, No. ZC22TISI0753.
Informed consent statement: The study was approved by the Institutional Ethics Committee of Seoul St. Mary's Hospital, which has waived the requirement to obtain informed consent (approval No. KC23ZASI0238). However, written informed consent for publication of medical information was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
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: Younghoon Kim, MD, PhD, Assistant Professor, Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, No. 222 Banpo-daero, Seocho-gu, Seoul 06591, South Korea. sellar1@snu.ac.kr
Received: August 13, 2023 Peer-review started: August 13, 2023 First decision: August 30, 2023 Revised: August 31, 2023 Accepted: September 12, 2023 Article in press: September 12, 2023 Published online: October 6, 2023 Processing time: 42 Days and 11.6 Hours
Abstract
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.
Core Tip: Gastric hamartomatous inverted polyps (GHIPs) are benign lesions that mostly present as small submucosal tumors or polyps that are easily removed by endoscopic procedures. We report a rare case of GHIP that presented as a large ulcero-infitrative mass that was removed by total gastrectomy and confirmed to be accompanied by gastric cancer. Our case highlights that GHIPs may be a predisposing factor for malignancy due to ulcerative changes. Furthermore, the unusual endoscopic features of GHIP broaden the outlook of physicians and emphasize the need for a thorough investigation of GHIPs including the importance of complete resection.
