A gastric elevated lesion of a 47-years-old woman was followed by endoscopy for 4 years from 1994, because histological findings of biopsy specimen showed as hyperplastic polyp. In 1998, 4 years later, biopsies were performed and histological study indicated hyperplastic polyp with severe atypia. The lesion was completely resected by endoscopic polypectomy. Pathohistological findings showed almost 70% of the total area was occupied with adenocarcinoma cells, and the rest was diagnosed as hyperplastic tissue. We reported a case of smooth surface elevated lesion in stomach which was finally diagnosed as carcinoma. These results suggested that biopsies from every part should be performed in order to diagnose gastric smooth surface elevated lesion, and complete resection by endoscopic polypectomy should be done.
