Background: With the increasing use of endoscopy, visually discernible abnormalities, such as polyps in the gastrointestinal tract, are encountered more often. Gastric polyps most frequently originate in the mucosa but encompass a broad spectrum of pathologic conditions that may even be submucosal or extrinsic. Found in 6% of upper endoscopies, gastric polyps are a heterogeneous group of epithelial and subepithelial lesions that can vary in histology, neoplastic potential, and management. Most have no risk of cancer, but there are certain subsets of polyps with malignant potential, necessitating further endoscopic treatment and/or periodic surveillance 1. Gastric adenomas, or gastric polypoid dysplasia, are true neoplasms and precursors to gastric cancer. Due to the increased risk of malignancy associated with these polyps, recommendations include complete removal of the adenoma, with further examination of the entire gastric mucosa for abnormalities, all of which should be biopsied.
Case report: Introduction: Patient description- Age: 65 Gender: male Race: Mongolian Height-168cm Weight- 80kg
Case history- Occasionally abdominal pain 2023.12.11 Gastric large polyp was diagnosed No chronic deseases Did not use alcohol or tobacco
Gastroscopy 2023.12.12 Pedunculated large polyp on the middle part of body Yamada type IV 2023.12.21 Pedunculated large polyp size 4.5х6,5 cm on the middle part of body Removed this polyp by hot snare and seven clips where done on the polyps base
2023.12.22 : Histology result
Well differentiated adenocarcinoma arising in villous adenoma IC10-C16
2023.01.15 Abdominal contrast CT Result: SPO gastric polypectomy with surgical clips along the stomach body, no significant abnormal wall thickness or enhancement of the stomach.
ConclusionsAround 10% of stomach polyps are adenomas, making them the most common precancerous type. They’re typically sporadic and solitary. But they can sometimes occur in greater numbers in association with familial adenomatous polyposis. Polyps are common in gastrointestinal endoscopy and are usually asymptomatic and do not progress to cancer, but histological examination is required to determine the presence of dysplasia. In this case, tissue analysis revealed a hyperplastic polyp, but post-operative material revealed a adenocarcinoma arising in villous adenoma of the stomach 2. Endoscopic removal of a large adenoma crop has fewer complications and recurrences, but it cannot completely eliminate the risk of cancer, so it is necessary to regularly monitor H. pylori for treatment. As long as the size of gastric adenoma is 2 cm or larger, there is a 40-50% risk of turning into cancer, so it is necessary to regularly monitor with an endoscope .