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      Regression of gastric endoscopic submucosal dissection induced polypoid nodular scar after Helicobacter pylori eradication: A case report

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          Abstract

          BACKGROUND

          Endoscopic submucosal dissection (ESD) is the treatment of choice for early gastric cancer and premalignant gastric dysplasia. In some cases, ESD induced ulcer heals as a polypoid nodular scar (PNS). These scars may make the physicians raise several clinical implications such as post-ESD neoplastic recurrence.

          CASE SUMMARY

          We described a case of gastric ESD induced PNS which is regressed after Helicobacter pylori (H. pylori) eradication. A 58-year-old male patient was referred to the outpatient clinic for evaluation and treatment of gastric low-grade dysplasia (LGD). ESD was performed. A PNS was developed at the ESD site. An endoscopic biopsy was done and there was no histological evidence of remnant tumor or recurrence but a hyperplastic mucosal change. The PNS showed increase in size in follow-up endoscopy, and the biopsy specimen demonstrated H. pylori infestation. H. pylori eradication was done and the PNS was regressed.

          CONCLUSION

          H. pylori eradication is considerable for the regression of PNS if H. pylori infestation is confirmed.

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          Most cited references9

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          Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer

          Chan Hyuk Park, Dong-Hoon Yang, Jong Kim … (2020)
          Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
          Article 0 comments Cited 54 times – based on 0 reviews     Review now
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            Evidence-Based Guidelines for the Treatment of Helicobacter pylori Infection in Korea 2020

            Hye-Kyung Jung, Seung Kang, Yong Chan Lee … (2021)
            Helicobacter pylori infection is one of the most common infectious diseases worldwide. Although the prevalence of H. pylori is gradually decreasing, approximately half of the world's population still becomes infected with this disease. H. pylori is responsible for substantial gastrointestinal morbidity worldwide, with a high disease burden. It is the most common cause of gastric and duodenal ulcers and gastric cancer. Since the revision of the H. pylori clinical practice guidelines in 2013 in Korea, the eradication rate of H. pylori has gradually decreased with the use of a clarithromycin-based triple therapy for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was mostly due to increased antimicrobial resistance, especially from clarithromycin. The clinical practice guidelines for the treatment of H. pylori were updated according to evidence-based medicine from a meta-analysis conducted on a target group receiving the latest level of eradication therapy. The draft recommendations developed based on the meta-analysis were finalized after an expert consensus on three recommendations regarding the indication for treatment and eight recommendations for the treatment itself. These guidelines were designed to provide clinical evidence for the treatment (including primary care treatment) of H. pylori infection to patients, nurses, medical school students, policymakers, and clinicians. These may differ from current medical insurance standards and will be revised if more evidence emerges in the future.
            Article 0 comments Cited 27 times – based on 0 reviews     Review now
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              Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps.

              Su Youn Nam, Bum Park, Kum Hei Ryu … (2016)
              Western guidelines recommend Helicobacter pylori eradication in H. pylori-associated gastric polyps, but Korean medical insurance does not approve its eradication. The aim of this study is to evaluate the effect of H. pylori eradication on gastric polyps.
              Article 0 comments Cited 17 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Byung Chul Jin
                Ae Ri Ahn
                Seong-Hun Kim
                Seung Young Seo
                Journal
                Journal ID (nlm-ta): World J Clin Cases
                Journal ID (publisher-id): WJCC
                Title: World Journal of Clinical Cases
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 2307-8960
                Publication date (Print): 6 December 2022
                Publication date (Electronic): 6 December 2022
                Volume: 10
                Issue: 34
                Pages: 12793-12798
                Affiliations
                Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, South Korea
                Department of Pathology, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, and Research Institute for Endocrine Sciences, Jeonju 56445, South Korea
                Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, South Korea
                Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, South Korea. bear7905@ 123456jbnu.ac.kr
                Author notes

                Author contributions: Jin BC analyzed clinical data and drafted the manuscript; Kim SH, Seo SY advised and reviewed the manuscript; Ahn AR performed the pathologic review.

                Corresponding author: Seung Young Seo, MD, PhD, Professor, Department of Internal Medicine, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, South Korea. bear7905@ 123456jbnu.ac.kr

                Article
                Other ID: jWJCC.v10.i34.pg12793
                DOI: 10.12998/wjcc.v10.i34.12793
                PMC ID: 9791497
                PubMed ID: 36579119
                SO-VID: a1c241e2-8766-4713-889b-575448ab74d5
                Copyright © ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                Date received : 4 October 2022
                Date revision received : 2 November 2022
                Date accepted : 8 November 2022
                Categories
                Subject: Case Report

                Keywords: polypoid nodular scar,helicobacter pylori,endoscopic submucosal dissection,case report
                Data availability:
                Keywords: polypoid nodular scar, helicobacter pylori, endoscopic submucosal dissection, case report

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