A Case of Large Pedunculated Stomal Polypoid Hypertrophic Gastritis

Abstract

A 55-year old woman was admitted to our hospital for dizziness due to severe anemia. She had undergone distal gastrectomy for gastric cancer 8 years earlier with no recurrence. Upper gastrointestinal endoscopy showed a large hemorrhagic polypoid mass at the gastric side of the gastroduodenal anastomosis. Since the possibility of malignancy could not be ruled out, total remnant gastrectomy was performed. Macroscopic examination of the resected specimen showed a large pedunculated polyp whose maximum diameter was 80 mm. Histopathological examination of this polypoid lesion showed stomal polypoid hypertrophic gastritis (SPHG). SPHG is generally a sessile polypoid lesion ; it is rare that SPHG forms such a large pedunculated polyp as in the present case. To the best of our knowledge, there are only 9 reports of pedunculated SPHG, including the present case, and the polypoid lesion of the present case is the largest. SPHG has also been considered a precancerous lesion. In cases in which malignancy cannot be ruled out, endoscopic or surgical treatment that serves both diagnostic and therapeutic purposes is required.