Yang QY, Xu J, Hu JW, Huang XD. Gastric adenocarcinoma of fundic gland mucosa arising in heterotopic gastric mucosa of the duodenum: A case report. World J Gastrointest Surg 2025; 17(4): 102730 [DOI: 10.4240/wjgs.v17.i4.102730]
Corresponding Author of This Article
Xiao-Dong Huang, MD, Professor, Chief Physician, Department of Gastroenterology, Yiwu Tianxiang Medical East Hospital, No. 188 Nanshan Road, Yiwu 322000, Zhejiang Province, China. xiaodonghuang2024@163.com
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/
Qun-Ying Yang, Jian-Wen Hu, Department of Gastroenterology, Dongyang People’s Hospital, Dongyang 322100, Zhejiang Province, China
Jing Xu, Department of Pathology, Affiliated Sir Run Run Shaw Hospital of Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Xiao-Dong Huang, Department of Gastroenterology, Yiwu Tianxiang Medical East Hospital, Yiwu 322000, Zhejiang Province, China
Author contributions: Yang QY and Huang XD cared for the patient; Yang QY and Xu J were involved doing a literature search and wrote the paper; Hu JW and Huang XD reviewed the manuscript and submitted the paper. All authors read and approved the final version.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and any accompanying images. All identifying details have been removed or anonymized to protect the patient’s privacy.
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: Xiao-Dong Huang, MD, Professor, Chief Physician, Department of Gastroenterology, Yiwu Tianxiang Medical East Hospital, No. 188 Nanshan Road, Yiwu 322000, Zhejiang Province, China. xiaodonghuang2024@163.com
Received: October 28, 2024 Revised: December 16, 2024 Accepted: February 11, 2025 Published online: April 27, 2025 Processing time: 152 Days and 19.5 Hours
Abstract
BACKGROUND
Heterotopic gastric mucosa (HGM) is the most common type of epithelial heterotopia, which can occur in any part of the gastrointestinal tract. The duodenum is one of the common sites of HGM. HGM is usually considered benign, and malignant transformation of HGM in the duodenum is extremely rare.
CASE SUMMARY
We reported a middle-aged man admitted to the hospital due to abdominal pain, whose gastroduodenoscopy revealed a polypoid uplift in the duodenum. The attending physician directly removed the lesion using a snare, histopathological analysis demonstrated multidirectional cellular differentiation on the basis of duodenal HGM. The hematoxylin and eosin stains of the duodenal lesion demonstrated HGM, the superficial mucosa exhibited gastric foveolar-type epithelium, numerous mucous glands were identified beneath the foveolar region. Additionally, focal areas displayed several signet-ring cell changes. Gastric foveolar-type epithelium was diffusely positivity for MUC5AC and Ki67. Numerous mucous gland was positivity for MUC6, partially positive for MUC2, pepsinogen I and H+/K+ ATPase. It was eventually diagnosed gastric adenocarcinoma of fundic gland mucosa on the basis of duodenal HGM.
CONCLUSION
We reported the first case of gastric adenocarcinoma of fundic gland mucosa arising in the duodenum on the basis of HGM. Although HGM is mostly benign, there is also a risk of carcinogenesis.
Core Tip: This case represents the first reported of gastric adenocarcinoma of fundic gland mucosa in the duodenum arising from heterotopic gastric mucosa. The article highlights a rare occurrence, which could be of great interest to medical professionals encountering similar cases. The collaboration between the gastroenterology and pathology departments in different hospitals shows the importance of interdisciplinary teamwork in diagnosing and treating complex medical cases.
