Diagnostic and therapeutic review of a rare gastric inflammatory fibroid polyps case with distinctive features: A case report

Abstract

BACKGROUND

Inflammatory fibroid polyps (IFPs) are generally considered as benign and relatively rare mesenchymal gastrointestinal tract tumors. IFPs can occur in any part of the gastrointestinal tract but are most prevalent in the stomach, particularly in the gastric antrum. With a low incidence in clinical practice and a lack of distinct endoscopic features, the preoperative diagnosis rate of IFP is disappointingly low, often leading to missed diagnoses or misdiagnoses.

CASE SUMMARY

A 43-year-old man, hospitalized with abdominal pain and distension, underwent his first gastroscopy in 2020, which revealed chronic superficial erosive gastritis. From 2021 to 2022, his condition progressed from antral ulcers to a 2.0 cm gastric antrum bulge of an unclear nature. After proton pump inhibitor treatment, the lesion shrank but did not heal completely. Following a thorough assessment using magnifying endoscopy with narrow-band imaging, gastric-enhanced computed tomography, and endoscopic ultrasonography, endoscopic submucosal dissection was performed on the identified lesion. A subsequent postoperative pathological examination conclusively diagnosed the lesion as an IFP. At 6 months follow-up, no recurrence or metastasis was observed, with good mucosal scar healing.

CONCLUSION

Through using multiple diagnostic and therapeutic test results, an IFP with an unusual morphology could be identified.

Keywords: Endoscopic submucosal dissection; Endoscopy; Gastric antrum; Inflammatory fibroid polyps; Rare mesenchymal tumors; Treatment; Case report

Core Tip: This article presents a rare case of inflammatory fibroid polyp (IFP) in the gastric antrum, tracking a dynamic change in the lesion from gastritis to a bulge. Advanced diagnostic methods such as magnifying endoscopy with narrow-band imaging, gastric-enhanced computed tomography, and endoscopic ultrasonography were combined for diagnosis and treatment. Postoperative pathological examination and immunohistochemistry findings confirmed the diagnosis. Endoscopic submucosal dissection is a safe and effective treatment with almost no recurrence. This case report may prompt clinicians to consider IFP when detecting bulge lesions during gastroscopy and to utilize multiple methods for diagnosis and evaluation.