Vanek's tumor: a rare cause of gastric outlet obstruction. Case report and literature review

Abstract

Vanek's tumor or inflammatory fibroid polyp (IFP) is a rare submucosal, mesenchymal tumor of the digestive tract, of unknown etiology. We present an unusual case of a 62-year-old female patient, investigated for intermittent nausea, vomiting, abdominal pain and anemia. Narrow-band imaging (NBI) endoscopy showed a polypoid tumor with normal coverage mucosa prolapsing through the pylorus. The tumor was surgically removed. Histopathological (HP) examination revealed the presence of spindle cells with uniform nuclei exhibiting no mitotic activity. The inflammatory cells were predominantly represented by eosinophils. The vascular component was prominent suggesting a vascular lesion. We put emphasis on the presentation of this particular case because of its scarcity among the other types of gastric polyps, suspicion for features of malignancy, and the particularities of the clinical presentation, consisting of intermittent gastric outlet obstruction ("ball valve syndrome") accompanied by weight loss and anemia. The differential diagnosis of other benign or malignant gastric lesions was based on endoscopic, computed tomography and HP aspects.