J Korean Surg Soc.  2010 Apr;78(4):249-252. 10.4174/jkss.2010.78.4.249.

Gastric Polyposis Associated with Gastric Cancer

• Park SS
• Ryu BY
• Kim HS
• Kim HK
• Choi YH
• Kim SJ

• KMID: 1750738
• DOI: http://doi.org/10.4174/jkss.2010.78.4.249

Abstract

Gastric polyps encompass a wide variety of lesions that most commonly arise from the gastric epithelium. However, coincidental gastric carcinomas have rarely been reported, being found in only 2~3% of patients with hyperplastic polyps. A 68-year-old male was admitted to our hospital for bleeding control of a gastric polyp. The gastroscopy shows numerous polyps in the entire gastric mucosa and a huge ulcer with bleeding. The bleeding of the gastric ulcer could not be controlled by gastroscopic procedures. So, we performed total gastrectomy for bleeding control. The pathologic findings shows poorly differentiated adenocarcinoma with hyperplastic polyps. We performed treatment with Cisplatin and 5-FU for two cycles. Two months postoperative, he was admitted due to dyspnea associated with ascites. We performed a ckeckup by computer tomography. It revealed cancer recurrence with lymphatic and liver metastasis, and diffuse massive ascites with mesenteric cake, and it suggested cancer peritonei.

Keyword

Gastric polyposis

MeSH Terms

Adenocarcinoma
Aged
Ascites
Cisplatin
Dyspnea
Epithelium
Fluorouracil
Gastrectomy
Gastric Mucosa
Gastroscopy
Hemorrhage
Humans
Liver
Male
Neoplasm Metastasis
Polyps
Recurrence
Stomach Neoplasms
Stomach Ulcer
Ulcer
Cisplatin
Fluorouracil

Figure

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  Fig. 1 Gastroscopy shows bloody oozing on the ulcerative lesion (A) and multiple polyps on the gastric wall (B).

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  Fig. 2 Gross finding; This shows multiple polyps on whole gastric epithelium and huge ulcerative lesion.

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  Fig. 3 Polypoid gastric tissue shows the transformation area from hyperplastic polyp to adenocarcinoma. The thick arrow represents the adenocarcinoma component. The thin arrow shows hyperplastic polyp (H&E, ×40).

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  Fig. 4 This polypoid mass is composed of adenocarcinoma component (H&E, ×40)

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  Fig. 5 Abdominal CT shows recurred cancer or conglomerated metastatic lymphadenopathy (about 5 cm in size) at the anastomosis site, mild splenomegaly (about 13 cm), liver metastasis and diffuse massive ascites with mesenteric cake formation.

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