Xue RX, Lu XY, Deng P, Wang LH, Yun YF. Misdiagnosis of gastric oxyntic gland adenoma as hyperplastic polyp: A case report. World J Gastrointest Oncol 2025; 17(9): 110505 [DOI: 10.4251/wjgo.v17.i9.110505]
Corresponding Author of This Article
Pei Deng, Associate Chief Physician, Department of Gastroenterology, Dongfang Hospital, Beijing University of Chinese Medicine, No. 6 Fangxingyuan 1 Unit, Fengtai District, Beijing 100078, China. 20240931686@bucm.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Rui-Xiang Xue, Pei Deng, Lin-Heng Wang, Department of Gastroenterology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
Xin-Yu Lu, Department of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
Yi-Fei Yun, Department of Intensive Care Unit, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
Co-first authors: Rui-Xiang Xue and Xin-Yu Lu.
Co-corresponding authors: Pei Deng and Lin-Heng Wang.
Author contributions: Xue RX and Lu XY wrote the manuscript and contributed equally as co-first authors; Deng P and Wang LH provided clinical supervision and contributed equally as co-corresponding authors; Yun YF analyzed the pathological diagnosis; and all authors contributed to drafting of the manuscript, and have read and approved the final version.
Supported by the National High Level Chinese Medicine Hospital Clinical Research Funding, No. 2025XZYJ04.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pei Deng, Associate Chief Physician, Department of Gastroenterology, Dongfang Hospital, Beijing University of Chinese Medicine, No. 6 Fangxingyuan 1 Unit, Fengtai District, Beijing 100078, China. 20240931686@bucm.edu.cn
Received: June 9, 2025 Revised: July 22, 2025 Accepted: August 20, 2025 Published online: September 15, 2025 Processing time: 99 Days and 15.5 Hours
Abstract
BACKGROUND
Gastric oxyntic gland adenoma is a rare neoplasm often misdiagnosed as a hyperplastic or fundic gland polyp due to nonspecific endoscopic features and the limitations of superficial biopsies, leading to diagnostic delays.
CASE SUMMARY
In 2020, a gastroscopy of a 47-year-old man revealed a 0.5 cm lesion that was diagnosed as a hyperplastic polyp by superficial biopsy. By 2022, the lesion had enlarged to 1.0 cm exhibiting firmness, bleeding tendency, and disrupted submucosal layers on endoscopic ultrasound. Repeat biopsies again suggested hyperplasia. Endoscopic submucosal dissection was performed, confirming the diagnosis of gastric oxyntic gland adenoma. Additional surgical resection confirmed negative margins, and no recurrence at the three-year postoperative follow-up. However, endoscopic ultrasound revealed localized thickening (1.2 mm) of the muscularis mucosae at the gastric lesser curvature, likely representing post-procedural fibrosis. The patient was clinically asymptomatic, and was advised to continue annual endoscopic monitoring.
CONCLUSION
This case highlights the necessity of deep biopsy or complete resection for diagnosis. We recommend long-term endoscopic surveillance post-resection and heightened clinical vigilance to mitigate misdiagnosis risks.
Core Tip: This study presents the first systematic documentation of gastric oxyntic gland adenoma from misdiagnosis to definitive diagnosis. A 47-year-old male underwent two misdiagnosed biopsies before definitive histopathological confirmation via endoscopic submucosal dissection. We highlight gastric oxyntic gland adenoma’s nonspecific endoscopic presentation and the diagnostic pitfalls of superficial biopsies. Proposing a “deep biopsy or complete resection and early intervention” strategy, three-year follow-up demonstrated a favorable outcome without recurrence. These findings underscore the necessity of standardized sampling and timely management to mitigate diagnostic delays and potential malignant progression, offering critical evidence to refine clinical protocols for this under-recognized neoplasm.
