Inayat F, Ur Rahman A, Wahab A, Riaz A, Zahid E, Bejarano P, Pimentel R. Gastric Inflammatory Fibroid Polyp: A Rare Cause of Occult Upper Gastrointestinal Bleeding.
J Investig Med High Impact Case Rep 2021;
8:2324709620936840. [PMID:
32602395 PMCID:
PMC7328486 DOI:
10.1177/2324709620936840]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Inflammatory fibroid polyps (IFPs) are rare mesenchymal lesions that can arise
throughout the gastrointestinal tract. These tumors represent less than 0.1% of
all gastric polypoid lesions and are frequently found incidentally on endoscopic
evaluation. While presenting symptoms depend on the location of the tumor,
gastric polyps commonly present with epigastric pain and early satiety. We
hereby delineate the case of a middle-aged female who presented with chronic
iron deficiency anemia and a positive fecal occult blood test. She underwent an
upper endoscopy, which revealed an actively oozing umbilicated lesion in the
gastric antrum. Endoscopic ultrasound divulged the submucosal origin of the
lesion. It was subsequently excised using endoscopic mucosal resection.
Pathologic examination of the resected specimen confirmed the diagnosis of
gastric IFP. Furthermore, we conducted a systematic literature search of the
MEDLINE database centered on gastric IFPs from January 2000 till March 2020. The
data on patient demographics, clinical features, endoscopic findings, lesion
site and size, and treatment approaches were collected and analyzed. This
article illustrates the overarching need for clinicians to be vigilant of
gastric IFPs presenting with initial clinical symptoms suggestive of occult
upper gastrointestinal bleeding. Prompt diagnosis and management of gastric IFPs
carry paramount importance to combat chronic unexplained iron deficiency anemia
following occult bleeding in such patients. A concoction of endoscopy, biopsy,
and immunohistochemical examination can be employed toward their prompt
detection. Although gastric IFPs have conventionally been treated with surgery,
endoscopic resection is now emerging as a safe and efficient therapeutic
modality.
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