Multiple gastric hyperplastic polyps with some malignant transformation diagnosed in the wake of a bleeding episode

Abstract

The patient was a 74-year-old man who was admitted with a drop in blood pressure and anemia during dialysis. He was referred to our hospital because upper gastrointestinal bleeding was suspected. Upper gastrointestinal endoscopy did not detect any active bleeding, but showed multiple hyperplastic polyps in the stomach. All polyps were less than 20 mm in size, but had increased since an examination performed two years prior. Other endoscopic findings suggestive of cancerous polyps included adhesion of white mucus and increased mucosal irregularity. The patient was also undergoing hemodialysis and oral anti-platelet drugs may promote bleeding. Additionally, the patient wished to receive treatment to reduce the risk of future bleeding. For diagnostic and therapeutic purposes, endoscopic mucosal resection was performed, and diagnosed foveolar hyperplastic polyps containing a focus of intramucosal carcinoma.