A case of early gastric cancer coexisting with a hyperplastic polyp

A 52-year-old woman consulted a local physician because of epigastric pain. Upper gastrointestinal endoscopy showed a slightly elevated polyp, about 10 mm in diameter, in the anterior wall of the upper gastric body. The patient was therefore referred to the Department of Gastroenterology, Kitasato University East Hospital. Helicobacter pylori was negative, and there was no atrophy of the gastric mucosa. A reddish gastric polyp was seen among multiple fundic gland polyps. Narrow band imaging showed an irregular microvascular pattern on the surface of the gastric hyperplastic polyp. Biopsy revealed a Group 4 tumor, so early gastric cancer was suspected. Endoscopic submucosal dissection was performed, and the patient was uneventfully discharged from the hospital. There were no complications. Histopathological examination showed partial intermingling of gland ducts on the top of the hyperplastic polyp. Adenocarcinoma arising from a gastric hyperplastic polyp was diagnosed. Complete en bloc resection was performed in accordance with current guidelines. Subsequently, the patient was followed up on an outpatient basis, and there was no evidence of metastasis or recurrence.