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4 . 2022

Giant inflammatory fibrous polyp of the stomach (literature review and clinical case)

Abstract

Background. Inflammatory fibrous polyp (IFP) is a rare benign mesenchymal tumor of the gastrointestinal tract with a poorly understood pathogenesis, predominantly localized in the antrum of the stomach.

The aims – to analyze publications on IFP of the gastrointestinal tract and present our own rare clinical observation of a giant inflammatory gastric fibrous polyp.

Material and methods. A brief analysis of the literature on inflammatory fibrous polyps of the gastrointestinal tract is presented. Due to the rarity of a giant inflammatory fibrous polyp of the stomach, we present our own clinical observation.

Results. A case of an 80-year-old patient with endoscopic treatment of a large IFP of the antrum of the stomach, prolapsing into the lumen of the duodenum, is presented.

Conclusion. The final diagnosis of mesenchymal tumors of the stomach, and therefore, the determination of the biological potential of these tumors, is possible only after a morphological study using an immunohistochemical method.

Keywords:inflammatory fibrous polyp; eosinophilic granuloma; gastric polypoid fibroma; fibroma with eosinophilic infiltration; polypoid eosinophilic granuloma; granuloblastoma; hemangiopericytoma; inflammatory pseudotumor and Vanek’s polyp

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Tyurina V.M., Verbovsky A.N., Setdikova G.R., Semenkov A.V., Novikova T.V., Vakurova E.S., Shikina V.E. Giant inflammatory fibrous polyp of the stomach (literature review and clinical case). Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (4): 29–37. DOI: https://doi.org/10.33029/2308-1198-2022-10-4-29-37  (in Russian)

References

1.     Almaghrabi H., Almaghrabi M., Al-Maghrabi H. Giant ileocecal inflammatory fibroid polyp: unique clinical presentation. Case Rep Surg. 2020; 2020: 8811404. DOI: https://doi.org/10.1155/2020/8811404  PMID: 32774977; PMCID: PMC7391106

2.     Konjetzny G., Uber magenfibrome, Beiträge zur Klinischen Chirurgie, vol. 119, pp. 53-61, 1920.

3.     Vanek J. Gastric submucosal granuloma with eosinophilic infiltration. Am J Pathol. 1949; 25 (3): 397–411. PMID: 18127133; PMCID: PMC1942901

4.     Helwig E.B., Ranier A. Inflammatory fibroid polyps of the stomach. Surg Gynecol Obstet. 1953; 96 (3): 335–67. PMID: 13038651.

5.     Fazzio C.S.J., Madeira E.B. Inflammatory fibroid polyp (Vanek’s polyp): a case report and literature review. J Bras Patol Med Lab. 2015. Vol. 51, N 2. P. 117–120.

6.     Garmpis N., Damaskos C., Garmpi A., Georgakopoulou V.E., Sakellariou S., Liakea A., et al. Inflammatory fibroid polyp of the gastrointestinal tract: a systematic review for a benign tumor. In Vivo. 2021; 35 (1): 81–93. DOI: https://doi.org/10.21873/invivo.12235   PMID: 33402453; PMCID: PMC7880787.

7.     Kwiatkowski A.P., Paśnik K. Large inflammatory fibroid polyp of cardia managed laparoscopically – a case report and review of the literature. Wideochir Inne Tech Maloinwazyjne. 2014; 9 (4): 623–6. DOI: https://doi.org/10.5114/wiitm.2014.46448  Epub 2014 Oct 29. PMID: 25562003; PMCID: PMC4280427.

8.     Konstantinov A.S., Shelekhova K.V. Inflammatory fibroid polyps: clinical-morphological review of rare nosology. Voprosy oncologii [Problems in Oncology]. 2018; 64 (2): 275–279. DOI: https://doi.org/10.37469/0507-3758-2018-64-2-275-279  (in Russian)

9.     Liu D., Wang J., Chen M., Xiao Q., Zhu C.R., Jiang J.X., et al. [Inflammatory fibroid polyp of the gastrointestinal tract: a clinicopathologic features of 37 cases]. Zhonghua Bing Li Xue Za Zhi. 2016; 45 (6): 381–6. (in Chinese). DOI: https://doi.org/10.3760/cma.j.issn.0529-5807.2016.06.006  PMID: 27256045.

10. Liu T.C., Lin M.T., Montgomery E.A., Singhi A.D. Inflammatory fibroid polyps of the gastrointestinal tract: spectrum of clinical, morphologic, and immunohistochemistry features. Am J Surg Pathol. 2013; 37 (4): 586–92. DOI: https://doi.org/10.1097/PAS.0b013e31827ae11e  PMID: 23426127.

11. Schildhaus H.U., Cavlar T., Binot E., Büttner R., Wardelmann E., Merkelbach-Bruse S. Inflammatory fibroid polyps harbour mutations in the platelet-derived growth factor receptor alpha (PDGFRA) gene. J Pathol. 2008; 216 (2): 176-82.

12. Lasota J., Wang Z.F., Sobin L.H., Miettinen M. Gain-offunction PDGFRA mutations, earlier reported in gastrointestinal stromal tumors, are common in small intestinal inflammatory fibroid polyps. A study of 60 cases. Mod Pathol. 2009; 22: 1049–56.

13. Fleres F., Mazzeo C., Ieni A., Rossitto M., Cucinotta E. Gastric inflammatory fibroid polyp tumor with acute intestinal obstruction – Vanek’s tumor can mimick a giant gastrointestinal stromal tumor or a gastric lymphoma. J Vis Surg. 2018; 4: 54. DOI: https://doi.org/10.21037/jovs.2018.02.09  PMID: 29682464; PMCID: PMC5897693.

14. Mori M., Kakeji Y., Adachi Y., Korenaga D., Sugimachi K. Non-polypoid inflammatory fibroid polyps concomitant with early carcinoma in the stomach. Eur J Surg Oncol. 1992; 18 (6): 632–5. PMID: 1478298.

15. Paikos D., Moschos J., Tzilves D., Koulaouzidis A., Kouklakis G., Patakiouta F., et al. Inflammatory fibroid polyp or Vanek’s tumour. Dig Surg. 2007; 24 (3): 231–3. DOI: https://doi.org/10.1159/000103326  Epub 2007 May 30. PMID: 17541268.

16. Pinto-Pais T., Fernandes S., Proença L., Fernandes C., Ribeiro I., Sanches A.,  et al. A large gastric inflammatory fibroid polyp. GE Port J Gastroenterol. 2015; 22 (2): 61-4. DOI: https://doi.org/10.1016/j.jpge.2014.07.006   PMID: 28868375; PMCID: PMC5580130.

17. Zinkiewicz K., Zgodzinski W., Dabrowski A., Szumilo J., Cwik G., Wallner G. Recurrent inflammatory fibroid polyp of cardia: a case report. World J Gastroenterol. 2004; 10 (5): 767–8. DOI: https://doi.org/10.3748/wjg.v10.i5.767  PMID: 14991958; PMCID: PMC4716929.

18. Huang W.H., Feng C.L., Lai H.C., Yu C.J., Chou J.W., Peng C.Y., et al. Endoscopic ligation and resection for the treatment of small EUS-suspected gastric GI stromal tumors. Gastrointest Endosc. 2010; 71 (6): 1076–81. DOI: https://doi.org/10.1016/j.gie.2009.12.041  PMID: 20438899.

19. Harima H., Kimura T., Hamabe K., Hisano F., Matsuzaki Y., Sanuki K., et al. Invasive inflammatory fibroid polyp of the stomach: a case report and literature review. BMC Gastroenterol. 2018; 18 (1): 74. DOI: https://doi.org/10.1186/s12876-018-0808-9  PMID: 29855265; PMCID: PMC5984322.

20. Zhang C., Cui M., Xing J., Shi Y., Su X. Massive gastrointestinal bleeding caused by a giant gastric inflammatory fibroid polyp: a case report. Int J Surg Case Rep. 2014; 5 (9): 571–3. DOI: https://doi.org/10.1016/j.ijscr.2014.05.004  Epub 2014 Jul 15. PMID: 25105769; PMCID: PMC4200880.

21. Martins C.R., Gamito É., Oliveira A.P. Ball valve syndrome caused by a giant gastric Vanek-s tumor. Rev Esp Enferm Dig. 2017; 109 (3): 237-8. DOI: https://doi.org/10.17235/reed.2017.4526/2016  PMID: 28190361.

22. Silva M., Albuquerque A., Cardoso H., Costa J., Macedo G. Gastric inflammatory fibroid polyp mimicking a gastrointestinal stromal tumour. Rev Esp Enferm Dig. 2016; 108 (8): 497–8. PMID: 27554383.

23. Gornals J.B., Loras C., Ornaque I., Botargues J.M. Giant gastric polyp resection using two poly loops and endoscopic submucosal dissection technique. Dig Endosc. 2012; 24 (3): 194. DOI: https://doi.org/10.1111/j.1443-1661.2011.01187.x  PMID: 22507101.

24. Yriberry Urena S., Vila Guitérrez S., Salazar Muente F. Polipectomía and manejo endoscópico de lesión gigante gástrica. Rev Gastroenterol Perú. 2010; 30 (2):167-71.

25. Niehues R., Domschke W., Pohle T. Endoscopic resection of a giant gastric polyp. Endoscopy. 2008; 40 (suppl 2): E50. DOI: https://doi.org/10.1055/s-2007-966882  Epub 2008 Feb 26. PMID: 18300199.

26. Aguilar Davidov B., Chablé Montero F., Medina Franco H. Pólipofibroide inflamatorio gástrico gigante. Reporte de caso yrevisión de la literatura. Rev Gastroenterol Mex. 2008; 73: 239-41.

27. Sebastián Domingo J.J., Ceña Lázaro G., Cabrera Chaves T., Charro Calvillo M., Navarro Dourdil M., Peña González E., et al. Pólipo fibroide inflamatorio gigante de estómago: manejo endoscópico [Giant inflammatory fibroid polyp of the stomach: Endoscopic management]. Gastroenterol Hepatol. 2014; 37 (5): 322-4. (in Spanish). DOI: https://doi.org/10.1016/j.gastrohep.2013.11.010  Epub 2014 Jan 18. PMID: 24447888.

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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