Sporadic Fundic Gland Polyps with Dysplasia or Carcinoma

What is it about?

Fundic gland polyps (FGPs) are the most frequent gastric polyps and have long been thought to be benign lesions with limited malignant potential, except in the setting of familial adenomatous polyposis.

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Why is it important?

However, the prevalence of FGPs has risen in recent years, paralleling the widespread and frequent use of proton pump inhibitors (PPIs). There have been a few reports of sporadic FGPs with dysplasia or carcinoma (FGPD/CAs) so far. In this review, we aimed to evaluate the clinical and endoscopic characteristics of sporadic FGPD/CAs and propose a management strategy of sporadic FGPs. The majority of patients with sporadic FGPD/CAs were middle-aged women on PPI medication who were not infected with Helicobacter pylori (H. pylori). The majority of sporadic FGPD/CAs were sessile and tiny, with a mean size of 5.4 mm, and occurred in the gastric body. During white light observation, the sporadic FGPs with cancer displayed redness, irregular surface structure, depression, or erosion, and irregular microvessels on the lesion surface during magnification narrow-band imaging. Furthermore, even with dysplasia, sporadic FGPs are likely to proceed slowly to malignancy. As a result, patients with sporadic FGPs do not require frequent endoscopy. If endoscopic findings other than conventional FGPs are found, regardless of their size, histological investigation is required.

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