Endoscopic resection of inflammatory gastric fibroid polyp: A case report

Abstract

An inflammatory fibroid polyp is a rare condition with frequent localisation in the antrum of the stomach. Because of the localisation in the bottom parts of the mucosa and submucosa, a histological diagnosis is difficult to establish at endoscopic biopsies. So, a correct diagnosis is histologically possible after surgical excision which is a common manner of treatment. Many authors have shown that endoscopic removal of an inflammatory fibroid polyp is possible. We are presenting a case of complete endoscopic resection of an inflammatory fibroid polyp of the stomach antrum in a 72-year-old patient. He comllained of nausea, vomiting and loss of appetite. The polyp endoscopically looked like flat elevation with central umbilication, 16 mm in diameter and it was localised praepylorically. Pathohistologically, areas of severe epithelial dysplasia were verified at endoscopic biopsies which suggested early gastric cancer. Helicobacter pylori (H. pylori) infection was verified histologically and with rapid urease test. The patient was treated with triple eradication H. pylori therapy. Two months after the therapy, we decided to perform endoscopic resection of the polyp. We applied a suction technique of mucosal resection by which the polyp was completely resected. After complete endoscopic removal, the final diagnosis of an inflammatory fibroid polyp localised in the submucosa and mucosa of the antrum of the stomach was histologically made. On follow-ups, after 3, 6 and 12 months, there were no endoscopic and histological signs of either inflammatory fibroid polyp relapse, or recurrence of H. pylori infection. The patient had no dyspeptic symptoms. We recommend an endoscopic method of resection as a therapy of choice for an inflammatory fibroid polyp of the stomach.