title: Hamartomatous inverted polyp successfully treated by endoscopic submucosal dissection.
abstract: We report a case of gastric hamartomatous inverted polyps that are a rare histological type of gastric polyp and difficult to diagnose. Gastric submucosal tumor was detected by upper gastrointestinal X-ray series in 37-year-old man. Endoscopy revealed a submucosal tumor (SMT) , which eroded with a depression on its surface in the fornix. Endoscopic ultrasonography showed a heterogeneous tumor in the third layer. Endoscopic submucosal dissection (ESD) was performed to resect the tumor completely. The pathological diagnosis was a gastric hamartomatous inverted polyp. The patient was later discharged without any complications. Hamartomatous inverted polyps without a stalk are classified as the SMT type because the tumor is inverted down growth into the submucosal layer, otherwise polyps with a stalk are classified as the polyp type. All of the polyps were resected endoscopically, however, surgical resection was performed for those of the SMT type, because it is difficult to remove this type completely by en-block resection using conventional EMR technique. ESD method may be indicated for SMT-type hamartomatous inverted polyps.
authors.affiliation: Department of Gastroenterology, Akita University School of Medicine, Akita, Japan. odashima@doc.med.akita-u.ac.jp
authors.forename: Masaru
authors.initials: M
authors.lastname: Odashima
authors.forename: Michiro
authors.initials: M
authors.lastname: Otaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nanjo
authors.forename: Mario
authors.initials: M
authors.lastname: Jin
authors.forename: Youhei
authors.initials: Y
authors.lastname: Horikawa
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Matsuhashi
authors.forename: Reina
authors.initials: R
authors.lastname: Ohba
authors.forename: Shigeto
authors.initials: S
authors.lastname: Koizumi
authors.forename: Nobukatsu
authors.initials: N
authors.lastname: Kinoshita
authors.forename: Taiji
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shima
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D005753:Gastric Mucosa / Q000601:surgery; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D008297:Male; D011127:Polyps / Q000473:pathology / Q000601:surgery*; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*