Synchronous double superficial mixed gastrointestinal mucus phenotype gastric cancer with gastritis cystica profunda and submucosal lipoma

Huang, Dandan; Zhan, Qiang; Yang, Shuiqing; Sun, Qi; Zhou, Zhiyi

doi:10.1097/md.0000000000010825

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…Based on this mechanism, we suspected that IFP growth under the mucosa triggered GCP formation in this case. In some reports, GCP has been considered as a high-risk factor for gastric cancer, and thus, its subsequent biological behavior and in uence on patient prognosis need to be studied [10]. (2) Inverted hyperplastic polyp (IHP).…”

Section: Diagnosismentioning

confidence: 99%

Invasive inflammatory fibroid polyp concomitant with Gastritis cystica polyposa and Inverted hyperplastic polyp of the stomach: a case report and literature review

yang,

Guo,

Meng

et al. 2024

Preprint

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Background Inflammatory fibrous polyp (IFP) is a distinct fibroblastic neoplasm with a predilection for the stomach and ileum. It contains prominent inflammatory infiltration, with a particularly eosinophils. Platelet-derived growth factor receptor alpha (PDGFRA) mutations are postulated as the pathogenesis of IFP. IFPs have been widely considered as benign tumors without malignant biological behaviors. However, rare invasive cases have been reported. Case presentation A 75-year-old woman presented with unexplained hematemesis, dizziness, and weakness for 3h. Physical examination revealed upper abdominal tenderness on palpation. Contrast-enhanced computed tomography revealed a 6 cm nodule with a high-density shadow and ring enhancement with well-defined borders in the gastric body. Surgical excision was performed, and subsequent histopathological examination and immunohistochemical analyses confirmed the dignosis of gastric infiltrative IFP presenting along with gastritis cystica polyposa (GCP) and inverted hyperplastic polyp (IHP). The patient was positive for CD34 and PDGFRA expression, but PDGFRA exon 12, 14, and 18 mutations were not identified. There was no evidence of recurrence within the 4 years of surgery. Conclusions To our knowledge, this is the second case of an IFP invading gastric’s serous layer and the first case of an IFP presenting with both GCP and IHP. Meanwhile, we speculate that the growth of an IFP leads to the formation of GCP and IHP. While an IFP is benign in most cases, it can be invasive in rare cases. It may show local recurrence with inadequate excision. We expect to help pathologists have a comprehensive understanding of the rare biological behavior, and to help surgeons achieve better clinical management through providing the case and literature review.

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Section: Diagnosismentioning

confidence: 99%

Invasive inflammatory fibroid polyp concomitant with Gastritis cystica polyposa and Inverted hyperplastic polyp of the stomach: a case report and literature review

yang,

Guo,

Meng

et al. 2024

Preprint

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“…Lipoma is located between the mucosal layer and the muscularis propria, which is adjacent to the lesion of early gastric cancer, indicating that these are usually concomitant tumors. [5][6][7] Huang et al [8] reported a case of gastric cancer with gastrointestinal lipoma with simultaneous doublesurface mixed gastrointestinal mucus phenotype, which suggests that the possibility of synchronous tumor should be considered in the clinic. In this study, we found 2 cases of duodenal lipomas with gastric cancer, which is consistent with previous studies.…”

Section: Potential Clinical Significance Of Duodenal Lipomamentioning

confidence: 99%

“…[4] Moreover, previous reports have described chemical lipoma complicated with gastric adenocarcinoma and signet ring cell carcinoma. [5][6][7][8][9] Therefore, attention should be devoted to lipoma in the clinic. However, duodenal lipoma is not easy to diagnose; as such, an effective diagnostic method(s) is needed.…”

Section: Introductionmentioning

confidence: 99%

“…Although the disease generally does not cause clinical symptoms, submucosal type duodenal lipomas can cause gastrointestinal bleeding, acute and chronic intestinal obstruction, and/or intussusception [4] . Moreover, previous reports have described chemical lipoma complicated with gastric adenocarcinoma and signet ring cell carcinoma [5–9] . Therefore, attention should be devoted to lipoma in the clinic.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic value and potential clinical significance of duodenal lipoma based on computed tomography imaging data

Liang

et al. 2021

Medicine

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Background:To explore the diagnostic value of computed tomography (CT) imaging for duodenal lipoma and the potential clinical significance of the findings.Methods:Clinicopathological and CT data from 57 patients, who were diagnosed with duodenal lipoma at the first affiliated Hospital of Zhengzhou University (Zhengzhou, China) between June 2014 and March 2019, were retrospectively reviewed. Data collected included location and size of the tumor, morphological manifestations (shape, density, boundary), concomitant diseases, pathology and gastroscopy results, and follow-up. Follow-up was performed via telephone, and surgical patients were followed-up for recurrence, metastasis and tumor size, and morphological changes. The follow-up period was up to January 2019.Results:Of the 57 patients with duodenal lipoma, contrast-enhanced scanning was performed in 7 cases. The tumor was located in the descending duodenum in 33 cases, the ascending in 4 cases, the horizontal in 16 cases, and the bulb in 4 cases. Mean tumor size was 13.0 ± 5.8 mm. CT morphological features of the tumor were as follows: tumor shape, round, quasi-round, or oval (n = 42); long strip (n = 3); nodular (n = 2); triangular (n = 1); and irregular lobulated (n = 9). Among the 57 patients, tumor density was homogeneous in 52 cases, inhomogeneous in 4 cases, and nodular with calcification in 1 case. The tumor boundary was classified as clear and with no capsule. Diseases concomitant with the tumor were as follows: gastritis (n = 23), gastric adenocarcinoma (n = 1), and gastric lymphoma (n = 1). Esophageal disease was found in 16 cases, including reflux esophagitis (n = 12) and esophageal cancer (n = 4). There were 13 cases of gallbladder and biliary disease, including cholecystolithiasis and cholecystitis (n = 9), common bile duct disease (n = 2), colorectal cancer (n = 4), lung cancer (n = 2), duodenal carcinoma with obstruction (n = 1), and ureteral space narrowing (n = 1).Conclusion:CT was an effective, non-invasive method for diagnosis of duodenal lipoma. CT imaging could clearly discern location, size, shape, and nature of duodenal lipomas. Duodenal lipoma can be associated with digestive tract inflammatory diseases and tumors in different locations, and its diagnosis is potentially valuable for their prevention and treatment.

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“…11,16,17 However, it is unclear whether there is a definite relationship and a specific mechanism, and these findings need to be confirmed by further studies. Whether GCP is regarded as benign or precancerous is still unclear, 18,19 and long-term follow-up is warranted.…”

mentioning

confidence: 99%

A retrospective analysis of 13 cases of gastritis cystica profunda treated by endoscopic resection and surgery

Wang

Chen

Cui

et al. 2022

J of Digest Diseases

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Synchronous double superficial mixed gastrointestinal mucus phenotype gastric cancer with gastritis cystica profunda and submucosal lipoma

Abstract: The diagnosis and treatment of synchronous double superficial gastric cancer with GCP and submucosal lipoma is challenging. In addition, elastic fiber staining and immune marker staining is effective and should be considered for diagnosis.

Cited by 5 publications

References 17 publications

Invasive inflammatory fibroid polyp concomitant with Gastritis cystica polyposa and Inverted hyperplastic polyp of the stomach: a case report and literature review

Invasive inflammatory fibroid polyp concomitant with Gastritis cystica polyposa and Inverted hyperplastic polyp of the stomach: a case report and literature review

Diagnostic value and potential clinical significance of duodenal lipoma based on computed tomography imaging data

A retrospective analysis of 13 cases of gastritis cystica profunda treated by endoscopic resection and surgery

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