A Giant Gastric Adenoma Embedded in the Duodenum

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pediatric Gastroenterology

Background:

• Gastric adenomas are neoplastic polyps, typically found in the stomach's antrum or fundus.
• Most gastric adenomas present as solitary, pedunculated masses.
• Giant gastric adenomas are exceptionally rare, particularly in pediatric patients.

Observation:

• A 17-year-old female presented with acute abdominal pain, nausea, vomiting, and melena.
• Emergency endoscopy revealed a giant gastric polyp (15 cm long pedicle, 15x3x4 cm size) protruding into the duodenum.
• The patient underwent surgical resection of the giant gastric adenoma.

Findings:

• Complete surgical removal of the giant gastric adenoma was achieved.
• The patient experienced no recurrence and remained in good health during a 5-year follow-up period.
• Histopathological analysis confirmed the adenomatous nature of the polyp, with no signs of malignancy at the time of resection.

Implications:

• Giant gastric adenomas necessitate timely endoscopic or surgical intervention to mitigate the risk of malignant transformation.
• Long-term endoscopic and ultrasonographic surveillance is crucial for early detection of gastric neoplasms in patients with a history of adenomas.
• This case underscores the importance of considering rare gastrointestinal pathologies in adolescents presenting with severe abdominal symptoms.