Gastric Juvenile Polyposis with Intramucosal Cancer Diagnosed by Magnifying Endoscopy with Narrow-band Imaging

Abstract

Although gastric juvenile polyposis (GJP) often coexists with gastric cancer, a preoperative accurate diagnosis is still difficult to obtain. A 70-year-old woman was referred for epigastralgia and anemia. Esophagogastroduodenoscopy with a conventional endoscope showed numerous gastric polyps with no cancerous findings. Magnifying endoscopy with narrow-band imaging (M-NBI) showed cancerous findings, and a target biopsy revealed adenocarcinoma. Histopathological findings after endoscopic resection confirmed a diagnosis of juvenile polyposis with intramucosal adenocarcinoma. Genetic analyses revealed a germline pathogenic variant of SMAD4. A target biopsy using M-NBI and endoscopic resection proved useful for confirming the preoperative diagnosis of coexisting cancerous lesions in GJP.

Importance of Magnifying Endoscopy in the Diagnosis and Management of Gastric Juvenile Polyposis Syndrome

“…However, because GJP is accompanied by numerous gastric polyps, it can be difficult to detect early-stage cancer or dysplasia by conventional endoscopy alone. Utsunomiya et al ( 5 ) reported a case of GJP with intramucosal gastric cancer that was diagnosed by a target biopsy using magnifying endoscopy (ME). This case report highlights the importance of utilizing advanced diagnostic techniques, such as ME, in the evaluation of gastrointestinal polyposis.…”