Inflammatory fibroid polyp of the gastrointestinal tract: 10 years of experience at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. / Pólipo fibroideo inflamatorio del tracto gastrointestinal: 10 años de experiencia del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.

BACKGROUND: Inflammatory fibroid polyp (lFP) is a rare, benign, and solitary neoplasm predominantly located in the gastric antrum and small bowel. Its clinical symptoms are heterogeneous and essentially depend on the location and size of the tumor. Definitive diagnosis is made through histopathology and this pathology has excellent long-term prognosis. AIM: To identify the cases of IFP seen at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán over a 10-year period. METHODS: A retrospective, cross-sectional, descriptive, and observational study was conducted that included patients with histopathologic diagnosis of IFP within the time frame of January 2001 and December 2011. RESULTS: Six cases were found and 5/6 (83.3%) of them were women. The median age was 41 years (minimum-maximum range of 19-56 years). The most frequent symptoms were weight loss (n=3), fever (n=2), nausea (n=2), and vomiting (n=2). Three patients presented with iron deficiency anemia and 2 cases with intussusception. The IFPs were located at the following sites: esophagus (n=1), stomach (n=2), small bowel (n=2), and colon (n=1). Treatment was surgical in 5/6 (83.3%) of the patients. CONCLUSIONS: IFPs are extremely rare in our population. They usually present with weight loss and iron deficiency anemia and are more frequently located in the stomach and small bowel. This is the largest reported IFP case series in a Mexican population.

Pólipo fibroide inflamatorio gástrico: presentación de un caso clínico patológico y revisión de la literatura / Inflammatory fibroid polyp of the gastrointestinal tract: clinical case and review of the literature

A case report of a 67 year old female presenting upper gastrointestinal symptoms characterized by epigastric pain and nausea. Her endoscopic examination reveals the presence of a polypoid submucosal lesion measuring 5 mm in diameter. Biopsies were reported as inflammatory fibroid polyp. Clinical pathological aspects, immunohistochemical findings, differential diagnosis and described new genetic alterations associated with this lesion are discussed.

Se presenta caso de paciente mujer de 67 años con sintomatología digestiva alta caracterizada por epigastralgia y náuseas. Su examen endoscópico muestra la presencia de lesión solevantada submucosa de 5 mm de diámetro. Las biopsias revelan la presencia de pólipo fibroide inflamatorio. Se discuten los aspectos clínico-patológicos, inmunohistoquímicos, diagnóstico diferencial y nuevas alteraciones genéticas descritas, asociadas a esta lesión.

Inflammatory fibroid polyp (Vanek’s polyp): a case report and literature review / Pólipo fibroide inflamatório (pólipo de Vanek): relato de caso e revisão da literatura

Inflammatory fibroid polyp (IFP) is a benign uncommon lesion (1%-4% of gastric benign lesions), originated from the submucosa of the gastrointestinal tract. Its origin is controversial and immunohistochemical studies of lesions have largely refuted the possible vascular, neural or smooth muscle origin. Recent studies suggest a neoplastic etiology due to a mutation, in some cases, in the alpha-type platelet-derived growth factor receptor gene (PDGFRa). Our objective is to report the case of a patient aged 70 years, with gastric IFP, comparing her immunohistochemical profile with those of other studies, and a brief review of the literature.

Pólipo fibroide inflamatório (PFI) é uma lesão benigna, pouco frequente (1%-4% das lesões benignas gástricas), originada na submucosa do trato gastrointestinal. Sua origem é controversa e vários estudos imuno-histoquímicos da lesão refutaram uma possível origem vascular, neural ou muscular lisa. Recentes estudos sugerem etiologia neoplásica devida à mutação, em alguns casos, no gene receptor tipo alfa para fator de crescimento derivado de plaquetas (PDGFRa). Nosso objetivo é relatar o caso de uma paciente de 70 anos de idade, com PFI gástrico, comparando seu perfil imuno-histoquímico com o de outros estudos, além de breve revisão da literatura.

[Small bowel intussusception and Vanek's tumor in an elderly woman]. / Intususcepción intestinal por pólipo fibroide inflamatorio en una anciana.

Inflammatory fibroid polyps are non-frequent benign lesions, described by Vanek in 1949, originated in the sub mucosa of the gastrointestinal tract. They have an uncertain origin and they are formed of fibroblastic and mesenchymal proliferations with an important eosinophilic proportion. Depending on where are they localized, could present different type of symptoms. The inflammatory fibroid polyps are one of the rare benign conditions causing intestinal intussusception in adults. We present the case of a 82 years old woman, who presented an intestinal intussusception due to an inflammatory fibroid polyp localized in the small bowel.

Intususcepción intestinal por pólipo fibroide inflamatorio en una anciana / Small bowel intussusception and Vanek's tumor in an elderly woman

El pólipo fibroide inflamatorio es un tumor benigno poco frecuente del tubo digestivo, descripto por Vanek en 1949. Son lesiones de etiología desconocida, originadas en la submucosa. Están formadas por células mononucleares y mesenquimatosas con citoplasma fusocelular, con una importante proporción de eosinófilos. Sus síntomas son variables, dependiendo de su localización, y son una r ara causa de intususcepción intestinal en adultos. Presentamos el caso de una mujer de 82 años, que sufrió una rara intususcepción de intestino delgado, originada en un pólipo fibroide inflamatorio.

Inflammatory fibroid polyps are non-frequent benign lesions, described by Vanek in 1949, originated in the sub mucosa of the gastrointestinal tract. They have an uncertain origin and they are formed of fibroblastic and mesenchymal proliferations with an important eosinophilic proportion. Depending on where are they localized, could present different type of symptoms. The inflammatory fibroid polyps are one of the rare benign conditions causing intestinal intussusception in adults.We present the case of a 82 years old woman, who presented an intestinal intussusception due to an inflammatory fibroid polyp localized in the small bowel.

Intususcepción intestinal por pólipo fibroide inflamatorio en una anciana / Small bowel intussusception and Vaneks tumor in an elderly woman

El pólipo fibroide inflamatorio es un tumor benigno poco frecuente del tubo digestivo, descripto por Vanek en 1949. Son lesiones de etiología desconocida, originadas en la submucosa. Están formadas por células mononucleares y mesenquimatosas con citoplasma fusocelular, con una importante proporción de eosinófilos. Sus síntomas son variables, dependiendo de su localización, y son una r ara causa de intususcepción intestinal en adultos. Presentamos el caso de una mujer de 82 años, que sufrió una rara intususcepción de intestino delgado, originada en un pólipo fibroide inflamatorio.(AU)

Inflammatory fibroid polyps are non-frequent benign lesions, described by Vanek in 1949, originated in the sub mucosa of the gastrointestinal tract. They have an uncertain origin and they are formed of fibroblastic and mesenchymal proliferations with an important eosinophilic proportion. Depending on where are they localized, could present different type of symptoms. The inflammatory fibroid polyps are one of the rare benign conditions causing intestinal intussusception in adults.We present the case of a 82 years old woman, who presented an intestinal intussusception due to an inflammatory fibroid polyp localized in the small bowel.(AU)

Tumor de Vanek o pólipo fibroide inflamatorio. Reporte de un caso / Vanek's tumor or inflammatory fibroid polyp. Report of a case

El tumor de Vanek o pólipo fibroide inflamatorio, se conoce como una lesión benigna, rara, de localización submucosa, no encapsulada, cuya ubicación puede darse a lo largo del tracto digestivo, siendo más común en el antro gástrico (80 %), aunque también se ha descrito en la unión gastroesofágica, duodeno, yeyuno, íleon y colon. Representa el tumor gástrico benigno menos frecuente (1-4 %), con ligero predominio en el sexo masculino y un pico de incidencia a partir de la sexta década de la vida, siendo la malignización un evento excepcional. En este reporte de caso se presentó un paciente masculino de 47 años de edad, con tumor de Vanek de localización antra, diagnosticado en el Hospital Provincial Universitario Arnaldo Milián Castro, de la ciudad de Santa Clara.

The Vanek's tumor or inflammatory fibroid polyp (IFP) is a rare benign lesion of submucosal location, not encapsulated, that may be located throughout the digestive tract, being more common in the gastric antrum (80%), although it has also been described in the gastroesophageal junction, duodenum, jejunum, ileum and colon. It is the less frequent benign gastric tumor (1-4%) with slight predominance in males and a peak incidence after the sixth decade of life, being its process of getting malignant an exceptional event. This case report presents a 47-year-old male patient with a Vanek's tumor of antral localization that was diagnosed at the Teaching Provincial Hospital Arnaldo Milian Castro, of Santa Clara.

Pólipo fibroide inflamatorio gástrico: a propósito de un caso / Inflammatory fibroid polyp

El pólipo fibroide inflamatorio o tumor de Vanek, es una lesión benigna, rara y de localización submucosa, cuya ubicación puede darse a lo largo del tracto digestivo, siendo más común en el antro gástrico (80%), aunque también se ha descrito en la unión gastroesofágica y con menos frecuencia en duodeno, yeyuno e íleon. En este informe, se presenta la revisión de un caso de pólipo fibroide inflamatorio diagnosticado en el Hospital Universitario de Santander en el 2009, la cual es de gran valor debido a la infrecuencia de la lesión y la escasa literatura local al respecto...

The inflammatory fibroid polyp or Vanek's tumor is a rare, benign lesion with submucosal localization , which location may be along the digestive tract, being more common in the gastric antrum (80%), although has also been described in the esophagogastric junction and less frequently in the duodenum, jejunum and ileum. In this report, it’s provided a review of a case of infl amatory fibroid polyp diagnosed at the Hospital Universitario de Santander in 2009, which is of great value because of the rarity of the injury and the limited local literature about it...