A Case of Hamartomatous Inverted Polyp Resembling a Submucosal Tumor

Shigeru Hibino, Katsuyoshi Ko, Makoto Katayama, Yutaka Ogura and Tetsuya Abe

Department of Surgery, Yamashita Hospital

A submucosal tumor at the fornix of the stomach was identified in a 63-year-old man six years previously. The patient was admitted to our hospital for a detailed endoscopic examination of the tumor, which had increased in size and showed a central del in the top region. Endoscopic ultrasonography showed a tumor with a clear boarder and a small low-echoic lesion in the third (submucosal) layer. These findings suggested that the tumor was not a typical submucosal tumor, such as a leiomyoma. Several non-echoic lesions were also seen in the tumor. We believed that these lesions represented a cystic component of the tumor. A fine needle aspiration biopsy was performed during the endoscopic ultrasonograpy, and a large number of monolayered cuboidal epithelium cells were identified. Both a complete removal of the tumor and a definitive diagnosis were thought to be impossible. A partial gastrectomy was thus performed for diagnosis and therapy. A histological analysis of the resected tumor specimen showed dilated cystic ducts composed of tall columnar epithelial cells, similar to those in gastric glands. The tumor was nonmalignant. From these findings, the lesion was histologically diagnosed as a hamartomatous inverted polyp.

Key words
submucosal tumor, hamartomatous inverted polyp, EUS-guided fine needle aspiration biopsy

Reprint requests
Shigeru Hibino Department of Surgery, Kiryu Kousei General Hospital
6-3 Orihime, Kiryu, 376-0024 JAPAN

Accepted
March 27, 2002

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