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gastric polyp

Etiology: - sporadic - proton pump inhibitors [5] - generally < 10 polyps - familial adenomatous polyposis coli Pathology: - gastric fundic gland polyps a) most common form of gastric polyp b) small, often multiple c) if sporadic, no defined risk of cancer - gastric adenoma - hyperplastic polyp Laboratory: - APC gene mutation - indicated for dysplastic polyps, adenomas, or family history of colorectal cancer [1] Special laboratory: - upper GI endoscopy with polypectomy for diagnosis - no follow-up upper GI endoscopy indicated for fundic gland polyps without dysplasia [1] - colonoscopy for familial adenomatous polyposis coli a) > 10 polyps b) > 40 years of age [1] c) indicated regardless of APC gene mutation status [1] Complications: - some gastric polyps (adenomas & hyperplastic polyps) have malignant potential [2] Management: - polypectomy of fundic gland polyps not routinely indicated unless > 1 cm [1] - endoscopic resection of large polyps (> 1 cm) & gastric adenomas [1] - reassurance for small (< 1 cm) fundic gland polyps without dysplasia Notes: - literature base is relatively weak - any recommendations must be viewed in light of this [2]

General

gastric neoplasm polyp

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018, 2021.
  2. Goddard AF, Badreldin R, Pritchard DM et al The management of gastric polyps. Gut. 2010 Sep;59(9):1270-6 PMID: 20675692
  3. Park do Y, Lauwers GY. Gastric polyps: classification and management. Arch Pathol Lab Med. 2008 Apr;132(4):633-40 PMID: 18384215
  4. Shaib YH, Rugge M, Graham DY, Genta RM Management of gastric polyps: an endoscopy-based approach. Clin Gastroenterol Hepatol. 2013 Nov;11(11):1374-84 PMID: 23583466
  5. Martin FC et al. Systematic review with meta-analysis: Fundic gland polyps and proton pump inhibitors. Aliment Pharmacol Ther 2016 Sep 15 PMID: 27634363