Inflammatory Fibroid Polyp or Vanek’s Tumour

Theageneio Hospital, Thessaloniki, Greece.
Digestive Surgery (Impact Factor: 2.16). 02/2007; 24(3):231-3. DOI: 10.1159/000103326
Source: PubMed


We report a case of a 65-year-old woman who presented with recurrent episodes of severe, postprandial abdominal pain followed by projectile vomiting. Gastroscopy revealed a large polyp in the prepyloric region. During peristalsis, the polyp was repeatedly 'passing' through the pylorus into the duodenal bulb, hence obstructing the lumen. The polyp was eventually removed in a piecemeal fashion. Histopathologic examination revealed an inflammatory fibroid polyp (known also as Vanek's tumour). A brief review on inflammatory fibroid polyps follows.

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Available from: Anastasios Koulaouzidis, Sep 21, 2014
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    • "Inflammatory fibroid polyps are well-circumscribed, solitary, small sessile or pedunculated lesions. The polyps usually do not reoccur after resection and, therefore, local excision is an adequate treatment [7, 8]. "
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    ABSTRACT: Goal. Surgeons that remove a typical polyp from the stomach or small intestine should be reluctant to accept a diagnosis of GIST just because there is a mutation in platelet-derived growth factor receptor alfa (PDGFRA). Background. A subtype of gastric and intestinal polyps is denoted as inflammatory fibroid polyp (IFP). In some of these cases a mutation in PDGFRA is found, leading to the diagnosis of gastrointestinal stromal tumor (GIST). Study. This study includes two patients that had polyps removed from the ileum, and an extended investigation was performed with immunohistochemical staining and mutation analyses. Results. The tumors did not show typical immunohistochemical staining for markers used to diagnose GIST, but the mutation analysis revealed a mutation in PDGFRA exon 12. On the basis of the mutation analysis, both polyps were primarily diagnosed as GISTs, but the diagnosis was later changed to inflammatory fibroid polyp. Conclusion. It is important that both surgeons and pathologists be aware that IFP can harbor a mutation in PDGFRA where further treatment and follow-up is different with the two different diagnoses. A mutation analysis can be misleading when taken out of the context of clinical observations, histological characteristics and immunohistochemical staining.
    Case Reports in Medicine 11/2013; 2013:845801. DOI:10.1155/2013/845801
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    • "Further immuneohistochemical analysis can demonstrate variable reactivity for actin, CD34, desmin, CD117 and S100 (3). Most IFPs are polypoid masses smaller than 5 cm, but occasional reports of larger sizes up to 20 cm have been reported(6–8).In most patients, in whom IFPs are located in thes mall bowel, the clinical picture is characterized by symptoms and signs of obstructive ileus, usually due to the intussusception, and rapidly becomes a surgical emergency (5–9). "
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    ABSTRACT: Inflammatory fibroid polyp (known also as Vanek's tumor) is a type of localized, non-neoplastic inflammatory pseudotumor or inflammatory myofibroblastic tumor that occurs most commonly in the stomach but also in the small and large bowel. It is a documented cause of intussusception in adults. We report a case of a 40-year-old woman who presented with severe, postprandial abdominal pain followed by projectile vomiting over a period of three days. Ultrasonography demonstrated a solid and echogenic mass surrounded by the typical mural layers of an invaginated jejunum. She underwent urgent laparotomy and resection of an 18 cm tumor from the distal jejunum. The immuno-histopathological diagnosis after segmental jejunal resection was a jejunal inflammatory fibroid polyp. Although inflammatory fibroid polyps are seen very rarely in adults, they are among the probable diagnoses that should be considered in obstructive tumors of the small bowel causing intussusceptions.
    Gastroenterology and hepatology from bed to bench 04/2013; 6(4):210-3.
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    • "Endoscopically, inflammatory polyps are usually less than 4 cm, but several cases of larger polyps up to 20 cm have been also reported. There is no clear evidence so far whether the polyp grows to a certain size or continues growing.11 In a previous case study, inflammatory polyps were detected in 18% of the small bowels, with the ileum the most frequent site. "
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    ABSTRACT: Inflammatory fibroid polyps are rare benign tumors of the GI tract, that commonly present with intestinal obstruction as a result of intussusceptions in the small bowel. A 39-year old man visited our clinic with an asymptomatic polypoid mass in the distal ileum that was identified on abdominal computed tomography for postoperative surveillance after total gastrectomy due to previously diagnosed early gastric cancer. Retrograde double-balloon enteroscopy was performed to diagnose the ileal mass and a complete resection of the polyp was performed using snare for polypectomy without complications. The final histological finding was an ileal inflammatory polyp. Balloon-assisted enteroscopy is a valuable modality to diagnose and treat small bowel lesions in lieu of surgical procedures in selected cases.
    Clinical Endoscopy 09/2012; 45(3):198-201. DOI:10.5946/ce.2012.45.3.198
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