Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2380-2386
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2380
Gastric pyloric gland adenoma resembling a submucosal tumor: A case report
Cong-Cong Min, Jun Wu, Feng Hou, Tao Mao, Xiao-Yu Li, Xue-Li Ding, Hua Liu
Cong-Cong Min, Jun Wu, Tao Mao, Xiao-Yu Li, Xue-Li Ding, Hua Liu, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Feng Hou, Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Author contributions: Min CC wrote the manuscript; Liu H performed the EUS and ESD for the patient and revised the article; Hou F contributed to the histopathology and immunohistochemistry; all other authors reviewed and approved the final manuscript to be published.
Supported by the National Natural Science Foundation of China, No. 81802777; Key Research and Development Plan of Shandong Province, No. 2018GSF118214; and China Postdoctoral Science Foundation, No. 2017M612221.
Informed consent statement: Written informed consent from the patient was obtained.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hua Liu, MD, Associate Chief Physician, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Qingdao 266003, Shandong Province, China. kaixing1407@sina.com
Received: February 6, 2020
Peer-review started: February 6, 2020
First decision: April 14, 2020
Revised: April 23, 2020
Accepted: May 14, 2020
Article in press: May 14, 2020
Published online: June 6, 2020
Abstract
BACKGROUND

Pyloric gland adenoma (PGA) is a recently described and rare tumor. Submucosal tumor (SMT)-like PGA is more difficult to diagnose and differentiate from other submucosal lesions.

CASE SUMMARY

We present the case of a 69-year-old man with a 10 mm SMT-like elevated lesion with an opening in the upper part of the gastric body, referred to our hospital for further endoscopic treatment. Magnifying endoscopy with narrow-band imaging, endoscopic ultrasonography, and complete endoscopic submucosal dissection were performed on the patient. Histopathological findings revealed tightly packed tubular glands lined with cuboidal or columnar cells that had round-to-oval nuclei containing occasional prominent nucleoli and an eosinophilic cytoplasm similar to that in non-neoplastic gastric pyloric glands. Additionally, immunohistochemical analysis showed positive staining for both mucin 5AC and mucin 6. Therefore, we arrived at the final diagnosis of gastric PGA. Although there was no apparent malignant component in this tumor, PGA has been considered a precancerous disease with a high risk of transformation into adenocarcinoma.

CONCLUSION

PGA should be considered when detecting gastric SMT-like lesions. Physicians and pathologists should focus on PGA due to its malignant potential.

Keywords: Pyloric gland adenoma, Submucosal tumor, Endoscopic submucosal dissection, Case report

Core tip: Pyloric gland adenoma continues to be a rare neoplasm of the stomach. We report a case where upper gastrointestinal endoscopy revealed a 10 mm submucosal tumor-like elevated lesion located in the upper part of the gastric body. Preoperative diagnosis is difficult because of the generally deep location of the tumor. Endoscopic ultrasound and endoscopic submucosal dissection were performed in this patient. The histopathological and immunohistochemistry investigations resulted in the diagnosis of pyloric gland adenoma.