Massive fundic gland polyposis in a patient receiving protracted proton-pump inhibitor medication.

A case of massive fundic gland polyposis (MFGPsis) in a female patient receiving protracted proton-pump inhibitor (PPI) medication is described. At gross examination the majority of the polyps were overlapping, confluent, some of them having a "cauliflower-like" configuration. The fundic gland polyps (FGP) arose in the gastric acid secretory mucosa. The confluence of these polyps impeded their enumeration. The gross and histological characteristics of this case seemed to be at variance with syndromic or sporadic cases having multiple FGP, inasmuch as in this case, the FGP had a propensity to agglutinate, to overlap and to develop confluent macrocysts. Another difference was that this disease, refractory to antacid treatment, required surgical intervention. This case substantiates the notion that protracted PPI medication may encourage the development of MFGPsis in susceptible individuals.