2018 Volume 60 Issue 9 Pages 1572-1578
We report a case of gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS). The patient was a 69-year-old female who had numerous fundic gland polyps (FGPs) and a whitish flat elevated area sized 5cm in the upper gastric body. She had no colon polyps endoscopically. Endoscopic findings showed an irregular reddish area in the whitish lesion, and the lesion was resected. Histological examination revealed that the area within the reddish part and the whitish lesion were gastric-type adenocarcinoma and adenoma, respectively. She eventually underwent total gastrectomy. We finally diagnosed this case as GAPPS after detection of a causal point mutation (c.-191T＞C) in the APC promoter 1B. It was found that her two sons also had similar FGPs and the same mutation in the gene. GAPPS is a unique gastric polyposis syndrome and patients with GAPPS are at high risk for gastric adenocarcinoma. When patients are diagnosed as having GAPPS, close follow-up is required.
