Zhang Fen-Ming, Ning Long-Gui, Wang Jing-Jie, Zhu Hua-Tuo, Feng Mei-Bao, Chen Hong-Tan
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
World J Gastrointest Surg. 2025 Aug 27;17(8):107558. doi: 10.4240/wjgs.v17.i8.107558.
An inflammatory fibrotic polyp (IFP) of the gastrointestinal tract is generally considered benign and noninvasive. An IFP in the duodenum is very rare. Here we report the case of an aggressive and infiltrative duodenal IFP resembling a malignancy and the patient subsequently underwent surgery. To the best of our knowledge, this is the first case of duodenal IFP invading the subserosa.
A 50-year-old female patient presented with recurrent epigastric pain for more than 1 month. Gastroscopy revealed a mass in the duodenal bulb involving the pylorus. Endoscopic ultrasound suggested that the lesion was a hypoechoic mass involving the muscularis propria, and duodenal bulb stromal tumor was considered based on abdominal computed tomography and gastric magnetic resonance imaging findings. A distal gastrectomy was subsequently performed. Based on the histopathology and immunohistochemical results, the lesion was finally diagnosed as duodenal IFP. The patient recovered well after surgery and had no recurrence at the 27-month follow-up.
This duodenal IFP invading subserosa indicates that IFP has specific invasion characteristics, and accurate diagnosis is critical to avoid inadequate treatment.
胃肠道炎性纤维性息肉(IFP)一般被认为是良性且无侵袭性的。十二指肠IFP非常罕见。在此,我们报告一例侵袭性和浸润性十二指肠IFP,类似恶性肿瘤,患者随后接受了手术。据我们所知,这是首例十二指肠IFP侵犯浆膜下层的病例。
一名50岁女性患者出现反复上腹部疼痛1个多月。胃镜检查发现十二指肠球部有一肿物,累及幽门。内镜超声提示病变为低回声肿物,累及固有肌层,根据腹部计算机断层扫描和胃磁共振成像结果考虑为十二指肠球部间质瘤。随后进行了远端胃切除术。根据组织病理学和免疫组化结果,最终诊断该病变为十二指肠IFP。患者术后恢复良好,在27个月的随访中无复发。
该例侵犯浆膜下层的十二指肠IFP表明IFP具有特定的侵袭特征,准确诊断对于避免治疗不足至关重要。