Abstract
A case of gastric hyperplastic polyp (HP) with focal carcinoma was reported. Before polypectomy, endoscopic finding and biopsy specimen revealed that this polyp was a HP with focal well-differentiated tubular adenocarcinoma at a part of the head of the polyp. The head and stalk of the polyp was removed completely by endoscopic polypectomy.
Endoscopic polypectomy was performed in 104 lesions (96 cases) at Kyoto National Hospital from 1976 to 1990. Histological study revealed that 85 of these lesions were HPs, but one case was a HP with focal carcinoma (1.20). Only large-sized polyps with focal or total malignant tissue or with some complications were removed, but others were followed up by endoscopic and histological examination. The incidence of HPs with focal carcinoma should be lower than 196 of all HPs in Japan.
At present, two opinions on the therapy of gastric HPs exist. One is that all gastric polyps should be removed and the other is that the resection of HPs without any complications and malignant tissues will not be necessary. However endoscopic apperances of HPs with focal carcinoma were not characteristic in our case and other reported cases. If a polyp is not removed and just followed up, then a careful biopsy and a histological study are necessary to demonstrate that the polyp has no malignant tissues.
