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      Prepyloric gastric inflammatory fibroid polyp presenting as chronic epigastric discomfort in a 5th decade aged female: A case report

      case-report

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          Highlights

          • •

            Inflammatory fibroid polyps is a rare entity that mostly occur in the stomach.

          • •

            Diagnosis is mainly postoperative with limited roles of usual diagnostic techniques.

          • •

            Histopathology and immunohistochemistry are the gold standard in diagnosis.

          • •

            Resection/surgery is the mainstay treatment.

          Abstract

          Introduction

          Inflammatory fibroid polyps is a rare entity that mostly occur in the stomach. Gastric type is usually asymptomatic or may show nonspecific symptoms. Diagnosis is mainly postoperative with limited roles of usual diagnostic techniques.

          Presentation of case

          A 42 years old healthy female presenting with chronic symptoms for epigastric discomfort and mild nausea. Labs showed mild anemia. A gastric lesion was detected by Endoscopy and being studied by echo-endoscopy and needle aspirate. Gastric Inflammatory fibroid polyp was diagnosed after distal gastrectomy by histopathology and immunohistochemistry.

          Conclusion

          Gastric inflammatory fibroid polyp is a preoperative diagnostic challenge of unclear pathogenesis. Histopathology and immunohistochemistry are the gold standard. Studies around this exact pathology are required for better management and prevention.

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          Most cited references4

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          Endoscopic Ultrasonography in the Diagnosis of Gastric Subepithelial Lesions

          Eun Gong, Do-Hoon Kim (2016)
          Subepithelial lesions occasionally found in the stomach of patients undergoing endoscopy may be either benign lesions or tumors with malignant potential. They may also appear due to extrinsic compression. Discrimination of gastric subepithelial lesions begins with meticulous endoscopic examination for size, shape, color, mobility, consistency, and appearance of the overlying mucosa. Accurate diagnosis can be achieved with endoscopic ultrasonography, which provides useful information on the exact size, layer-of-origin, and characteristic morphologic features to support a definitive diagnosis. Endoscopic ultrasonography also aids in the prediction of malignant potential, especially in gastrointestinal stromal tumors. Features of subepithelial lesions identified on endoscopic ultrasonography can be used to determine whether further diagnostic procedures such as endoscopic resection, fine needle aspiration, or core biopsy are required. Endoscopic ultrasonography is a valuable tool for diagnosis and clinical decision making during follow-up of gastric subepithelial lesions.
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            Enhanced recovery after surgery (ERAS) and fast-track in video-assisted thoracic surgery (VATS) lobectomy: preoperative optimisation and care-plans

            Antonio D’Andrilli, Erino A. Rendina (2018)
            Main specific interventions for preoperative clinical optimisation of patients undergoing lung cancer surgery include assessment and treatment of comorbidities, minimizing preoperative hospitalization, minimizing preoperative fasting, and optimisation of antibiotic and thrombo-embolic prophylaxis. Preoperative patient optimisation is considered a crucial part of enhanced recovery after thoracic surgery pathways. Potentially, advantages of this fast-track management could be even higher when considering video-assisted thoracic surgery (VATS) major lung resection, because reduced trauma related to minimally invasive techniques is one of the main factors improving postoperative outcome. Literature data and clinical evidences in this setting are reported and discussed.
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              Inflammatory Fibroid Polyp: An Unusual Cause of Abdominal Pain in the Upper Gastrointestinal Tract a Case Report

              Huan Wang, Tiejun Zhou, Cuiwei Zhang … (2020)
              Abstract Inflammatory fibroid polyps (IFPs) tend to occur in the gastrointestinal tract, and they are rare and benign neoplasms. In general, IFPs often come from epithelial tissue. The gastric antrum is the most common location. Endoscopic ultrasound (EUS) often shows a predominantly hypoechoic mass with well-defined borders originating from the submucosal area. Here, we report the case of a 46-year-old woman with abdominal pain who underwent computed tomography (CT), endoscopic ultrasound and endoscopic submucosal dissection (ESD) of resected specimens; the diagnosis was ultimately an inflammatory fibroid polyp. She is currently in clinical remission.
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                Author and article information

                Contributors
                Jad J. Terro
                Etienne El-Helou
                Alaa Kansoun
                Alaa Taha
                Jocelyne Karaki
                Jessica Naccour
                Nahed Damaj
                Houssam Khodor Abtar
                Journal
                Journal ID (nlm-ta): Int J Surg Case Rep
                Title: International Journal of Surgery Case Reports
                Publisher: Elsevier
                ISSN (Electronic): 2210-2612
                Publication date PMC-release: 25 September 2020
                Publication date Collection: 2020
                Publication date (Electronic): 25 September 2020
                Volume: 76
                Pages: 49-51
                Affiliations
                [a ]General Surgery Department, Faculty of Medical Sciences, Lebanese University, Mount Lebanon, Lebanon
                [b ]Department of Gastroenterology and Endoscopy, Central Military Hospital, Beirut, Lebanon
                [c ]Emergency Medicine Department, Faculty of Medical Sciences, Lebanese University, Mount Lebanon, Lebanon
                [d ]General Medicine Department, Faculty of Medical Sciences, Lebanese University, Mount Lebanon, Lebanon
                [e ]Department of General Surgery, Central Military Hospital, Beirut, Lebanon
                Author notes
                [* ]Corresponding author. j.terro@ 123456hotmail.com
                Article
                Publisher Item ID: S2210-2612(20)30825-7
                DOI: 10.1016/j.ijscr.2020.09.152
                PMC ID: 7530196
                PubMed ID: 33010615
                SO-VID: ec20ce7c-7041-472a-9373-ca972b77da85
                Copyright © © 2020 The Author(s)
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 6 September 2020
                Date revision received : 22 September 2020
                Date accepted : 22 September 2020
                Categories
                Subject: Case Report

                Keywords: gastric inflammatory fibroid,gastric polyp,chronic abdominal pain,surgical resection,diagnostic challenge,case report
                Data availability:
                Keywords: gastric inflammatory fibroid, gastric polyp, chronic abdominal pain, surgical resection, diagnostic challenge, case report

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