Gastric hamartomatous polyp without polyposis coli: Radiologic diagnosis

Sato, Tadayuki; Sakai, Yoshiko; Ishiguro, Shingo; Fujita, Makoto; Kuriyama, Kinya; Narumi, Yasuo

doi:10.1007/bf01889016

Cited by 9 publications

(4 citation statements)

References 16 publications

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“…Gastric hamartomatous polyps are rare, being found in less than 0.1% of all endoscopic examinations. [15][16][17] Only 27 cases of gastric hamartomatous polyps have been reported in Japan, including our case. There does not seem to be any gender preponderance and the patients ranged in age from 8 to 85 years old.…”

Section: Discussionmentioning

confidence: 85%

Diagnosis and Treatment of a Gastric Hamartomatous Inverted Polyp: Report of a Case

et al. 2004

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Gastric hamartomatous polyps are rare and difficult to diagnose. We report the case of a 43-year-old woman admitted to our hospital after an upper gastrointestinal series revealed a submucosal tumor. Upper gastrointestinal endoscopy showed a submucosal tumor (SMT), which was eroded with a depression on its surface, in the upper corpus. Endoscopic ultrasonography showed a heterogeneous tumor in the third layer. A laparoscopic wedge resection of the stomach allowed us to perform complete resection of the tumor, which measured 2.8 cm in diameter. The pathological diagnosis was a gastric hamartomatous inverted polyp. The postoperative course was uneventful. Only 27 cases of gastric hamartomatous polyps have been reported in Japan. Hamartomatous inverted polyps without a stalk are classified as the "SMT type" because the tumor is inverted into the submucosal layer, whereas polyps with a stalk are classified as the "polyp type." All of the polyps in past reports were resected endoscopically; however, laparoscopic wedge resection may be indicated for SMT-type hamartomatous inverted polyps larger than 2.0 cm in diameter.

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Section: Discussionmentioning

confidence: 85%

Diagnosis and Treatment of a Gastric Hamartomatous Inverted Polyp: Report of a Case

et al. 2004

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“…Most studies have also shown a similar age range (11,12,16,17). Although many studies have reported a female predominance (11,12,14,16,17,19), other studies have not (15).…”

Section: Discussionmentioning

confidence: 91%

“…This selection criterion was based on a review of the (scant) literature that reported the distribution of polyps per case in the setting of patients on proton pump inhibitors (PPI), which suggested a possible bimodal distribution (15), with the number of 10 polyps as a potentially useful discriminator between those with and without SFGP. This potential bimodal distribution is less apparent in studies of patients that were conducted before the widespread use of PPI (11,12,16,17).…”

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confidence: 94%

Sporadic Fundic Gland Polyposis: A Clinical, Histological, and Molecular Analysis

et al. 2002

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Sporadic fundic gland polyposis (SFGP) is defined as multiple fundic gland polyps in patients without familial adenomatous polyposis syndrome (FAP). Although little is known about the genetic changes in SFGP, mutations in the Wnt signaling pathway have been recently linked to fundic gland polyps in other settings: sporadic polyps are linked to activating beta-catenin mutations, whereas FAP-associated fundic gland polyps are caused by second somatic hits in the adenomatous polyposis coli gene. The relationship between SFGP, single sporadic fundic gland polyps, and FAP-associated polyps remains unclear, and SFGP remain poorly characterized at the clinical, histological, and molecular levels. A retrospective study was undertaken of eight patients with SFGP who had >/=10 polyps with at least five endoscopic biopsy specimens available for study. One additional patient with attenuated FAP who underwent partial gastrectomy was included as a control. The medical records and biopsy specimens were reviewed. Mutations of the beta-catenin gene were evaluated in each fundic gland as well as in control nonpolypoid tissue by direct sequencing of a mutational hot spot in exon 3 of the beta-catenin gene, which encodes the GSK-3beta phosphorylation sites, and a HinfI endonuclease digestion assay. The four men and four women in the study were an average of 57 years of age at biopsy. All patients were on acid-suppression therapy, 5/8 with proton-pump inhibitors (PPI) and 3/8 with Zantac. Sixty-two polyps were studied, and all were <10 mm, with most between 2 and 7 mm. The polyps were histologically identical to single sporadic fundic gland polyps. No dysplasia was seen. Forty-seven of 62 polyps (76%) had detectable beta-catenin mutations. Mutations were found in all eight of the patients. All were point mutations in codons 32, 33, 34, and 37 and are either phosphorylation sites or immediately adjacent to phosphorylation sites, findings identical to that seen in single sporadic fundic gland polyps. Each polyp had a single mutation, and each patient had more than one unique mutation (median = 4), indicating a multifocal origin for the polyps. No mutations were found in nonpolypoid control tissue and in polyps from the attenuated FAP patient. The patients with SFGP in this series were all between 40 and 70 years of age and had histories of acid-suppressive therapy. The fundic gland polyps were histologically and genetically identical to single sporadic fundic gland polyps and demonstrated frequent somatic activating mutations in exon 3 of the beta-catenin gene.

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“…Solitary hamartomatous polyps of stomach are rare in adult, found in less than 0.1% of all endoscopic examinations . The differential diagnosis includes solitary juvenile polyps and Peutz‐Jeghers‐type polyps .…”

Section: Take Home Messagementioning

confidence: 99%