Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Rd. Siriraj Subdistrict, Bangkok-noi, Bangkok, 10700, Thailand.
Vikit Viranuvatti Siriraj GI Endoscopy Center, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Case Rep. 2023 Apr 26;17(1):167. doi: 10.1186/s13256-023-03893-2.
Villous adenoma is the one subtype of adenomatous polyp that is very uncommon in the stomach. Data regarding clinical characteristics, natural history, and prognosis were scarce.
This report presented an 87-year-old Thai woman with a large gastric villous adenoma incidentally revealed in a computed tomography of chest for the evaluation of right pleural effusion. The esophagogastroduodenoscopy demonstrated a huge, glossy, proliferative polypoid mass involving gastric cardia, fundus, and a lesser curve of the upper body. The pathological report confirmed villous adenoma with low grade dysplasia. Although surgical resection was suggested, the patient denied any treatment due to advanced age and multiple comorbidities. She was generally well after 12 months of clinical and radiologic surveillance.
From literature review, only 14 cases of gastric villous adenoma were reported to date. Most of the lesions were large and symptomatic. Malignancy presented in 43% of the cases. Nevertheless, our patient remained asymptomatic without surgical removal following a 12-month period.
绒毛状腺瘤是胃腺瘤性息肉中非常罕见的一种亚型。关于其临床特征、自然病史和预后的数据很少。
本报告介绍了一位 87 岁的泰国女性，因右侧胸腔积液的评估而行胸部计算机断层扫描时偶然发现巨大的胃绒毛状腺瘤。食管胃十二指肠镜检查显示胃贲门、胃底部和上体小弯处有一个巨大的、有光泽的、增生性息肉样肿块。病理报告证实为低级别异型增生的绒毛状腺瘤。尽管建议进行手术切除，但由于患者年龄较大且合并多种疾病，拒绝任何治疗。经过 12 个月的临床和影像学监测，她一般情况良好。
通过文献回顾，目前仅报道了 14 例胃绒毛状腺瘤。大多数病变较大且有症状。43%的病例存在恶性肿瘤。然而，我们的患者在 12 个月后仍无症状，未进行手术切除。
