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Case Reports
. 2016 Jan 22;87(ePub):S2239253X16024658.

Inflammatory fibroid polyp (Vanek's tumor) of the gastric antrum: is treatment always mandatory?

Giovanni Rizzo, Alessandro Fancellu, Alberto Porcu
  • PMID: 26845412
Case Reports

Inflammatory fibroid polyp (Vanek's tumor) of the gastric antrum: is treatment always mandatory?

Giovanni Rizzo et al. Ann Ital Chir. .

Abstract
in English, Italian

Introduction: Inflammatory fibroid polyp (IFP), also known as Vanek's tumor, is a rare polypoid lesion of the gastrointestinal tract. A recently observed case led us to review the literature, with the aim to discuss the management of asymptomatic gastric IFPs.

Case report: A 71-year-old man was endoscopically diagnosed as having a polypoid lesion located in the gastric antrum. Histopathological and himmunoistochemical studies of endoscopic biopsies revealed an IFP. Endoscopic resection was proposed, but the patient refused such a treatment because he was asymptomatic for his polyp. After three years the patient is asymptomatic and the endoscopic surveillance follow-up has showed no evidence of growth nor other modifications of the gastric IFP.

Discussion: Gastric IFPs are benign polyps of unknown etiology which sometimes pose problems of differential diagnosis with GISTs, and various mesenchymal tumors. Although gastric IFPs are benign lesions usually asymptomatic, most of the cases reported in the literature have been treated by endoscopic or surgical excision. In the case described herein, no modifications of the polyp were observed at endoscopic follow-up.

Conclusion: This case description suggests that removal of gastric IFPs, either by endoscopic or surgical approach, may not be mandatory in asymptomatic patients.

Key words: Inflammatory Fibroid Polyp, Stomach, Vanek's tumor.

I polipi fibroidi infiammatori, detti anche tumori di Vanek, dal medico che per primo li descrisse nel 1949, sono lesioni dal comportamento benigno che possono svilupparsi lungo i diversi tratti dell’apparato gastro-enterico. Riportiamo il caso di un uomo di 71 sottoposto ad accertamenti endoscopici per sanguinamento digestivo occulto. L’esofagogastroduodenoscopia evidenziò, come reperto occasionale, una lesione polipoide semipeduncolata dell’antro gastrico, risultata essere agli esami istologici e immunoistochimici un tumore di Vanek. Venne pertanto proposta al paziente una resezione endoscopica delle lesione, che il paziente rifiutò in quanto la lesione non era responsabile di alcuna sintomatologia. Venne pertanto eseguito un follow-up endoscopico; dopo tre anni il paziente rimane asintomatico e il tumore di Vanek risulta immodificato I tumori di Vanek dello stomaco sono quasi sempre asintomatici, a differenza di quelli localizzati nel tenue che spesso esordiscono con sanguinamento o intussuscezione. Dal punto di vista diagnostico pongono problemi di diagnosi differenziale con i GIST e con altri tumori ad origine mesenchimale. Il comportamento biologico dei tumori di Vanek è quello di lesioni benigne, ciononostante i casi riportati in letteratura sono stati trattati con escissione endoscopica o resezione gastrica (open o laparoscopica). Il caso qui riportato suggerisce che i tumori di Vanek dello stomaco in pazienti asintomatici possono anche essere seguiti con il solo follow-up endoscopico.

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