Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
권호 표지

A Case of Signet Ring Cell Carcinoma with Hyperplastic Polyp in the Remnant Stomach after Subtotal Gastrectomy

위 아전절제 후에 생긴 과형성 위용종에서 발생한 인환세포암

  • Lee, Myung-Hyun (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Chung, Woo-Chul (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Jung, Sung-Hoon (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kwak, Jae-Wuk (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Sung-Jun (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Paik, Chang-Nyol (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Kang-Moon (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
  • 이명현 (가톨릭대학교 의과대학 내과학교실) ;
  • 정우철 (가톨릭대학교 의과대학 내과학교실) ;
  • 정성훈 (가톨릭대학교 의과대학 내과학교실) ;
  • 곽재욱 (가톨릭대학교 의과대학 내과학교실) ;
  • 김성준 (가톨릭대학교 의과대학 내과학교실) ;
  • 백창렬 (가톨릭대학교 의과대학 내과학교실) ;
  • 이강문 (가톨릭대학교 의과대학 내과학교실)
  • Received : 2009.11.04
  • Accepted : 2010.03.01
  • Published : 2010.05.30
⟨ Previous Next ⟩

Abstract

Hyperplastic polyps are usually found in the stomach and they account for 50 to 90% of all gastric epithelial polyps. In contrast to the adenomatous polyps, it has been reported that most hyperplastic polyps are benign. However, in rare cases hyperplastic polyps have revealed carcinoma, and the incidence of malignant changes is generally recognized to be about 1 to 3%. Most of the reported cases of a hyperplastic gastric polyp with a transformation to adenocarcinoma were well differentiated histopathologically. Herein we report on an extremely rare case that involved the association of a hyperplastic polyp and focal signet ring cell carcinoma in the remnant stomach after subtotoal gastrectomy.

과형성 위용종은 위의 전정부에서 흔히 볼 수 있는 병변으로 전체 위용종의 50~90%으로 알려져 있다. 샘종성 위용종은 흔히 악성으로 진행할 가능성이 있는 전암성 병변으로, 과형성 용종은 양성으로 알려져 있다. 과형성 위용종은 암과의 관련성에 대한 통일된 의견이 없는 상태이나, 극히 일부의 경우, 즉 1~3%에서 암으로 진행하는 것으로 보고하고 있다. 악성화가 되더라도 조직학적으로는 분화가 좋은 샘암을 동반하지만, 매우 드물게 분화도가 나쁜 샘암종이나 인환세포암을 포함하기도 한다. 이번 증례는 위 아전절제술 후에 남아있는 잔위에서 과형성 위용종과 인환세포암이 동반된 거대 용종이 발견된 경우로서 문헌 고찰과 함께 보고한다.

Keywords

References

  1. Kamiya T, Morishita T, Asakura H, Munakata Y, Miura S, Tsuchiya M. Histoclinical long-standing follow-up study of hyperplastic polyps of the stomach. Am J Gastroenterol 1981;75:275-281.
  2. Ohkusa T, Takashimizu I, Fujiki K, et al. Disappearance of hyperplastic polyps in the stomach after eradication of Helicobacter pylori. A randomized, clinical trial. Ann Intern Med 1998;129:712-715. https://doi.org/10.7326/0003-4819-129-9-199811010-00006
  3. Glick SN, Teplick SK, Amenta PS. Giant hyperplastic polyps of the gastric remnant simulating carcinoma. Gastrointest Radiol 1990;15:151-155. https://doi.org/10.1007/BF01888761
  4. Daibo M, Itabashi M, Hirota T. Malignant transformation of gastric hyperplastic polyps. Am J Gastroenterol 1987;82:1016-1025.
  5. Lee SS, Jang MK, Lee GH, et al. A gastric hyperplastic polyp with intramucosal adenocarcinoma. Korean J Gastrointest Endosc 2004;28:188-192.
  6. Heo WS, Chae KH, Jung JH, et al. Two cases of adenocarcinoma arising from gastric hyperplastic polyp. Korean J Gastrointest Endosc 2005;31:399-403.
  7. Fry LC, Lazenby AJ, Lee DH, Monkemuller K. Signet-ring-cell adenocarcinoma arising from a hyperplastic polyp in the stomach. Gastrointest Endosc 2005;61:493-495. https://doi.org/10.1016/S0016-5107(04)02640-9
  8. Hizawa K, Fuchigami T, Iida M, et al. Possible neoplastic transformation within gastric hyperplastic polyp. application of endoscopic polypectomy. Surg Endosc 1995;9:714-718.
  9. Ryu SH, Shin SR, Kim KH, Seo GS, Choi SC. A case of a gastric hyperplastic polyp with a signet ring cell carcinoma. Korean J Gastrointest Endosc 2008;36:376-379.
  10. Ginsberg GG, Al-Kawas FH, Fleischer DE, Reilly HF, Benjamin SB. Gastric polyps: relationship of size and histology to cancer risk. Am J Gastroenterol 1996;91:714-717.
  11. Zea-Iriarte WL, Sekine I, Itsuno M, et al. Carcinoma in gastric hyperplastic polyps. A phenotypic study. Dig Dis Sci 1996;41:377-386. https://doi.org/10.1007/BF02093832
  12. Kozuka S, Masamoto K, Suzuki S, Kubota K, Yokoyama Y. Histogenetic types and size of polypoid lesions in the stomach, with special reference to cancerous change. Gann 1977;68:267-274.
  13. Orlowska J, Jarosz D, Pachlewski J, Butruk E. Malignant transformation of benign epithelial gastric polyps. Am J Gastroenterol 1995;90:2152-2159.
  14. Mochizuka A, Uehara T, Nakamura T, Kobayashi Y, Ota H. Hyperplastic polyps and sessile serrated 'adenomas' of the colon and rectum display gastric pyloric differentiation. Histochem Cell Biol 2007;128:445-455. https://doi.org/10.1007/s00418-007-0326-2
  15. Park SJ, Kim HG, Yang JH, et al. A case of adenocarcinoma arising in hyperplastic polyp in the stomach. Korean J Gastrointest Endosc 2003;27:153-157.
  16. Jee SR, Choi SR, Ryu SH, et al. A case of adenocarcinoma arising from hyperplastic polyp in the stomach. Korean J Gastroenterol 2001;38:207-210.
  17. Shatney CH, Lorber PH, Gilbertsen VA, Sosin H. The treatment of pedunculated adenomatous colorectal polyps with focal cancer. Surg Gynecol Obstet 1974;139:845-850.
  18. Kim JH, Lee YC, Kim H, et al. Endoscopic resection for undifferentiated early gastric cancer. Gastrointest Endosc 2009;69:e1-e9. https://doi.org/10.1016/j.gie.2008.10.040
  19. Yokota T, Kunii Y, Teshima S, et al. Signet ring cell carcinoma of the stomach: a clinicopathological comparison with the other histological types. Tohoku J Exp Med 1998; 186:121-130. https://doi.org/10.1620/tjem.186.121
  20. Baik SH, Hyung WJ, Lee JH, Lee KY, Noh SH, Min JS. The clinicopathologic characteristics and prognosis of gastric signet ring cell carcinoma. J Korean Surg Soc 2000;59:771-777.