Hamartomatous Inverted Polyp Successfully Treated by Endoscopic Submucosal Dissection

Odashima, Masaru; Otaka, Michiro; Nanjo, Hiroshi; Jin, Mario; Horikawa, Youhei; Matsuhashi, Tamotsu; Ohba, Reina; Koizumi, Shigeto; Kinoshita, Nobukatsu; Takahashi, Taiji; Shima, Hitoshi; Watanabe, Sumio

doi:10.2169/internalmedicine.47.0360

Cited by 30 publications

(35 citation statements)

References 8 publications

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“…For SMT-type lesions larger than 10 mm in diameter, surgical resection is performed 5. Furthermore, approximately 20 % of GHIPs coexist with precancerous or cancerous areas 6 7 8. In our patient, the diameter of the SMT was about 15 mm, so we selected ESD rather than conventional EMR to achieve a complete en bloc resection and obtain an accurate pathological diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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A case of gastric hamartomatous inverted polyp resected endoscopically

Dohi¹,

Gen

Yoshioka³

2016

Endosc Int Open

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We report the case of a 55-year-old woman with a tumor in the greater curvature of the upper gastric body. The tumor was incidentally found on an upper gastrointestinal X-ray series performed during a routine medical examination. Whereas endoscopy revealed a gastric submucosal tumor (SMT), endoscopic ultrasonography demonstrated a heterogeneous tumor with small, cystic, hypoechoic spots originating from the second layer. The patient was clinically asymptomatic, with no contributory family history or abnormal laboratory data. The results of a physical examination, abdominal computed tomography, and plain chest radiography were all unremarkable. Although the endoscopic tumor type was determined to be SMT, the tumor was successfully resected by endoscopic submucosal dissection (ESD) and subsequently diagnosed as a gastric hamartomatous inverted polyp (GHIP). The findings of the present case highlight the importance of considering GHIP as a diagnosis and indicate the utility of en bloc resection of GHIP with ESD.

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Section: Discussionmentioning

confidence: 99%

“…According to a search of the PubMed database, only four reports have described GHIP removal by ESD 4 7 8 9. The resection of an SMT-type GHIP by ESD is thus quite rare.…”

Section: Discussionmentioning

confidence: 99%

A case of gastric hamartomatous inverted polyp resected endoscopically

Dohi¹,

Gen

Yoshioka³

2016

Endosc Int Open

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“…Polyptype IHP can be removed by endoscopic resection (4,8), while surgical resection should be considered for the SMTtype lesions or larger lesion of any type, because of the difficulty of removing it in one piece (5,7). Considering the possibility of coexisting adenocarcinoma in gastric IHP, en bloc resection is preferred to avoid residual cancer cells and relapse (11).…”

Section: Discussionmentioning

confidence: 99%

A Pedunculated Submucosal Lesion in the Stomach with Inverted Downgrowth

Miyamoto

Muguruma

Okamura³

et al. 2014

Intern. Med.

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A 70-year-old man with a gastric lesion was referred to our hospital because of an unusual pedunculated lesion in the gastric body. Endoscopic ultrasound showed scattered cystic lesions within a heterogeneous area confined to the submucosal layer. Endoscopic mucosal resection was performed to obtain a precise diagnosis, as well as for removal. The lesion was histopathologically diagnosed as a heterotopic submucosal gland. We herein describe this rare type of gastric polyp and provide a literature review.

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“…GHIP are diagnosed using the pathological characteristics of the tumor, including the fibroblast cells, smooth muscle proliferation, nerve components, vasoformative tissue, glandular hyperplasia, and cystic gland dilatation [2,3] . GHIP > 20 mm in diameter are recommended to be treated with an en bloc resection with laparoscopic wedge resection of the stomach or endoscopic submucosal resection (ESD) rather than a conventional polypectomy, endoscopic mucosal resection (EMR) with piecemeal resection, or subtotal or total gastrectomy because there is a paucity of studies regarding the long term outcomes of GHIP and these polyps occasionally contain paracancerous portions (approximately 20% of GHIP) [2][3][4] . Furthermore, there are some controversial reports regarding the pathogenesis or natural growth history of GHIP.…”

Section: Introductionmentioning

confidence: 99%