Inflammatory fibroid polyp in the antrum co-occurring with adenomatous polyp in the ascending colon

Inflammatory fibroid polyps (IFP), also known as Vanek tumours, are one of the rarest group of gastrointestinal tract polyps. They represent 0.1–3.0% of all polyps in this organ system [1]. They are defined as benign neoplastic lesions projecting from the submucosa or mucosa, consisting of spindle stromal cells with infiltration of eosinophils. Most common location is the stomach, mainly the antrum (70%), ileum (19%), and colon (6%) [2]. Depending on size and location, IFP can be asymptomatic or occurring with abdominal pain, gastrointestinal bleeding, weight loss, and vomiting. Large polyps of the stomach can cause intermittent obstruction, described as “ball valve syndrome” [3]. There is also the possibility of intussusception presenting with acute abdomen when the polyp arises below the Treitz ligament [1, 4].
Our paper presents a case report of a female patient who was diagnosed with IFP co-occurring with adenomatous polyp of ascending colon.
A 59-year-old woman was admitted to the Chair and Department of Gastroenterology with Endoscopic Unit for planned polypectomy. Previously she had been treated in an outpatient clinic, where colonoscopy and esophagogastroduodenoscopy (EGD) were performed three months prior to admission. During colonoscopy no lesions were found up to the splenic flexure, but it was not possible to examine the further part of the colon. During EGD a polyp in the antrum was found and biopsied. Histopathological examination of the specimen revealed chronic gastritis and the features of hyperplastic polyp.
On admission the patient reported a lack of appetite, constipation, and weight loss (16 kg within a year). Physical examination revealed abdominal pain in the upper right quadrant with no abnormal reactions. Esophagogastroduodenoscopy performed in the hospital found a polyp in the antrum of about 10 mm diameter on a wide base, which was resected using a diathermic snare. Histopathologically, inflammatory fibroid polyp was diagnosed.
Colonoscopy under general anaesthesia was also performed. It revealed a longitudinal polyp, placed on a fold of about 12 mm in length, which was biopsied. Histopathology report indicated tubular adenoma with high-grade dysplasia. The patient was referred to a surgical clinic for further treatment. Endoscopic mucosal resection was performed resulting in successful removal of the whole lesion, complicated however by profuse bleeding. The patient remains under the care of an...


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