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Polipi želuca pronalaze se u 1-8 % endoskopija gornjeg gastrointestinalnog trakta, najčešće kao slučajan nalaz. Hiperplastični polipi želuca (HPŽ) čine 30-93% otkrivenih polipa, čest su nalaz u zemljama s visokom prevalencijom H.pylori infekcije. Procjenjuje se da je rizik za neoplastičnu transformaciju unutar polipa u rasponu od 1,5 do 4,5 %, pri čemu je prevalencija nastanka adenokarcinoma izvan HPŽ veće nego unutar polipa (6% vs. 2%). U ovoj retrospektivnoj studiji koristili smo uvid u medicinsku dokumentaciju, nalaze endoskopske obrade i biopsije u 36 pacijenata koji su u periodu od 2012. do 2021. hospitalizirani na Zavodu za gastroenterologiju KBCSM zbog resekcije HPŽ. Cilj studije bio je prikazati trendove recidiviranja i pojave karcinoma unutar HPŽ, rizične čimbenike u nastanku i transformaciji, te pokušati definirati preporuku o resekciji i praćenju ovih polipa. U inicijalnoj obradi identificirano je 36 bolesnika sa 144 polipa od čega je resecirano 98 HPŽ. Više su bili zastupljeni muškarci (63,9%), medijan dobi bio je 71,5, a prosječan broj polipa po pacijentu 3,8. Polipi su bili smješteni antralno u 75% pacijenata, a simptome je imalo 58,3% bolesnika. Primarni recidiv HPŽ zabilježen je kod 50% pacijenata nakon inicijalne resekcije. U univarijatnoj analizi statistički značajnim za recidiv pokazao se broj reseciranih polipa (RR 5,14 uz CI 95% 1,17-22,48 p=0,03), te ne uzimanje ASK (0,18 uz CI 95% 0,040-0,820, p=0,027). Faktori ipak nisu značajni u multivarijatnoj analizi. Tijekom perioda praćenja, neoplastičnu transformaciju HPŽ zabilježi se u 19,4% svih sudionika, od čega je adenokarcinom utvrđen u 5,5% sudionika. Medijan perioda praćenja do pojave displazije je 9,5 mjeseci, dok je u slučaju recidiva 7,5. Na temelju Kaplan-Meierovih krivulja preživljenja, optimalni period za praćenje da bi se otkrili recidivi i displazija je procjenjen na 12 mjeseci. Dobivena učestalost recidiviranja i neoplastične transformacije u grupi pacijenata, ako se podaci obrađuju kao pacijent-slučaj, veća je od opisane u literaturi. Kao optimalni period praćenja nakon resekcije HPŽ, procjenjuje se na 12 mjeseci zbog toga se otkriva većina recidiva i displazija u HPŽ., Gastric polips are an incidental finding in 1 to 8 % upper GIT endoscopies and hyperplastic gastric polyps (HGP) account for 30 to 93% of cases. The incidince is higher in countries with high H. pylori infection prevalence, but as the eradication strategies progress, the rate of HGP is falling. Studies estimate that the overall risk for neoplastic transformation in the polyp to be 1,5 – 4,5%. It is considered that the risk for adenocarcinoma development is higher in the adjacent mucosa than in the polyp itself (6% vs 2%). In this retrospective study an analysis of medical records, endoscopy and biopsy results of 36 patients that were reffered to KBCSM Gastroenterology department for endoscopic GHP removal from 2009 to 2021 was conducted. The aim od this study is to define the trends and risk factors for HGP reccurence and neoplastic transformation in our patient group, as well as to review the resection and follow-up protocols. A number of 36 patients, initially presented with 144 HGP of which 98 were resected endoscopically. The HGP in our patients are situated antrally (75%), multiple in number (3,8 per person), tend to occur in men (63,9%) and the average patients' age was 71,5 years. Symptoms were described in 58,3% of the patients with HGP. After iniatial resection, 50% of our patients with HGP had a primary reccurence. A univariant analysis found the number of resected polyps (RR 5,14,CI 95% 1,17-22,48 p=0,03) and not belonging to the acetylsalicyc acid therapy group(RR 0,18,CI 95% 0,040-0,820, p=0,027) as factors that are statistically significant for recurrence, but multivariant analysis did not follow through. During the follow up, 19,4% of the patients developed neoplastic changes in HGP, but no risk factors were proven significant in an univariate analysis. The median reccurence period is 6,5 months, while neplastic change was discovered after a median of 9,5 months since resection of GHP. The period of 12 months is consider to be the cut-off point to discover most recurrences and neoplastic changes. Finally, this study did show that the rates of recurrence and neoplastic transformation to be higher than expected in the literatureAlso, a follow up period of 12 months after the resection was confirmed to be the best option for follow-up and early neoplastic change detection.

Osseous metaplasia (OM), or heterotopic ossification, refers to the formation of bone at extra-skeletal sites. It has been documented in various solid tumors including gastrointestinal (GI) tumors but the occurrence of this phenomenon in benign gastric polyps is very rare. The literature lacks information on its etiology as well as clinical outcomes and prognosis.

Key Clinical Message Stromal ossification has been reported in relation with gastrointestinal (GI) cancers. Heterotopic ossification of benign gastric polyps with bone formation is rarely documented and sometimes associated with calcification. Thus, the presence of foci of metaplastic bone (FMB) does not always imply GI cancer.

Hyperplastic polyps are by far the most common benign tumors in the stomach larger than 5mm. Although the malignant potential of hyperplastic gastric polyps was originally denied, a low risk for carcinomatous conversion is now recognized. Its has been recommended that all gastric polyps of 5mm or more in diameter have to be removed. We present here the case of a large hyperplastic gastric polyp located at the esophagogastric junction with endoscopic malignant appearance. The description of its endoscopic and histological characteristics gives us the opportunity to discuss the difficulty of endoscopic diagnosis in the case of gastric polyps and to remind their prognosis.

Copyright: © 2015 Chen P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. *Corresponding author: Sangeeta Agrawal, Associate Professor of Medicine, Dept. of Internal Medicine, Division of Gastroenterology, Wright State University, Dayton VA Medical Center, USA, Tel: 937-268-6511, ext 2698; Fax: 937-262-2154; E-mail: Sangeeta.Agrawal@va.gov

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The formation of carcinoma in the hyperplastic gastric polyp is extremely rare. This paper presents two cases of carcinomas which developed in hyperplastic polyps of the stomach in a 39-year-old man and an 82-year-old man. The problem of malignant transformation of gastric hyperplastic polyps is stressed and discussed in the light of data in the literature.

The purpose of this workshop is to apply basic principles of radiologic-pathologic correlation to the differential diagnosis of diseases of the stomach and duodenum. Tumors and inflammatory or reactive processes will be emphasized and used as illustrative examples in the syllabus.

Although there have been earlier reports on the use of three-dimensional endoscopic systems in the gastrointestinal tract, real-time three-dimensional imaging has not previously been described. This paper presents experience in three cases with a novel endoscopic system for three-dimensional observation in clinical situations. Case 1 was a hyperplastic gastric polyp, the shape of which was considerably enhanced in comparison with two-dimensional endoscopic viewing. Case 2 was an advanced esophageal cancer, in which the sense of depth was improved in the esophagus. Case 3 was a depressed early gastric cancer, the shape of which was also enhanced. Between July 2001 and March 2002, three experienced endoscopists also used this new system in a further 34 patients. A three-dimensional endoscopic environment was visible with the system in all patients, and all of the endoscopists were able to obtain visual information regarding spatial depth. This experience suggests that the three-dimensional video-endoscopic system used here can be of value in gastrointestinal endoscopy.

An infant presented with hematemesis and gastric outlet obstruction. Preoperative diagnosis of duodenal duplication cyst was based on a collaboration of radiological studies. At exploration the patient was found to have a gastric polyp that had intussuscepted into the duodenum leading to obstruction and hypergastrinemia secondary to gastric mucosa in the duodenal alkaline environment.