Villous adenoma of the stomach

Abstract

Villous adenomas are common neoplasms in the rectum and distal colon. They occur less frequently in the remainder of the gastrointestinal tract but irrespective of location are associated with a high malignant potential. The stomach is an unusual site of involvement and only approximately 100 cases have been recorded. Gastric villous lesions may be multiple and may coexist with an independent gastric carcinoma or be associated with neoplasms elsewhere in the gastrointestinal tract.Gastric villous tumors demonstrate carcinomatous changes in from 25 to 72% of cases, and complete surgical removal is mandatory for cure. Since preoperative endoscopic frozen section examinations and frozen section studies at operation are unreliable in detecting carcinomatous changes, the surgeon may be faced with a difficult decision in choosing the proper operative procedure. Lesions located in the proximal stomach pose a more difficult problem in surgical judgment than do distally located lesions, particularly when multiple frozen section studies fail to reveal malignant features and yet the possibility of carcinoma exists. Such a case is described and the operative approach is outlined.

Gastric villous adenoma: a case report and review of the literature

“…Its rarity comes along with the highest rate of malignant transformation of 29–40%, while only a 5% rate of malignant transformation was observed with gastric tubular adenoma [ 8 ]. The macroscopic characterization of gastric villous adenoma revealed a soft, polypoid epithelial mass with long papillary projections and intervening deep fissuring [ 9 ]. Microscopic appearance showed finger-like projection with villous features more than 75% of the polyp.…”

“…This is probably due to the absorptive potential of the rest of the entire bowel. An extensive literature search from inception to July 2022 on clinical data of gastric villous adenoma only yielded reports of 14 cases from 9 case series (Table 1 ) [ 9 – 12 , 15 – 19 ]. The mean age of these patients was 67 years, with a slight female predilection.…”