A 64-year old man was visited to our hospital with melena. Esophagogastroduodenoscopy revealed gastric ulcer and submucosal tumor of 20 mm in diameter with central depression located at the posterior wall of middle gastric body. Endoscopic ultrasonography revealed anechoic lesion of 14 mm in diameter at the third layer and we diagnosed as lymphangioma. 8 years later, esophagogastroduodenoscopy revealed submucosal tumor with hyperplastic-like elevated lesion of 20 mm in diameter. One and a half years later, esophagogastroduodenoscopy revealed submucosal tumor of 35 mm in diameter with hyperplastic-like flat elevated lesion and central depression. One year later, endoscopic ultrasonography revealed multiple anechoic lesions at the second and third layer and we diagnosed as hamartomatous inverted polyp. Endoscopic submucosal dissection was performed and pathological examination of resected specimen revealed inverted growth of mucosa and muscularis mucosa into submucosal layer and cystic-like proliferation of gastric glands.
