Endoscopic mucosal resection of a large inflammatory fibroid polyp (Vanek’s tumor): a case report Resection of Vanek’s tumor

Main Article Content

Carmelo Buda
Claudia Garipoli
Giuseppa Penna
Antonio d'Aquino
Claudio Galletti
Alessio Facciolà
Francesco Fedele


inflammatory fibroid polyp - endoscopic mucosal resection – PDGFRA – BRAF - CD34


Vanek’s Tumor (inflammatory fibroid polyp) is a rare benign mesenchymal lesion occurring throughout the digestive tract. Classical Vanek’s tumor (“gastric”) contains concentric formations of proliferating spindle cells, which are CD34 positive. Atypical-inflammatory pseudotumor-like Vanek’s tumor (“intestinal”) lacks concentric formations and is CD34 negative. A 70-years-old man patient presented during hematochemical routine tests, sideropenic anemia and leukopiastrinosis. The patient performed osteomyelitis biopsy and esophagogastroduodenoscopy (EGD) showing a gastric wall with nodular appearance and, in antrum pre-pyloric, a polypoid pedunculated lesion, measuring approximately 3 cm in diameter, surrounded by hyperemic mucosa. The lesion then was removed by en bloc endoscopic mucosal resection (EMR) and histo-morphological, immune-cytochemical and biomolecular evaluations were performed. The data were compatible with a benign polyp fibroid inflammatory (Vanek's Tumor). The results of this study suggest that endoscopic mucosal resection is a safe and efficacy solution for the resection of these gastrointestinal polyps and the two morphological patterns of Vanek’s tumor more probably represent only variants of one type of tumor than two different lesions. BRAF mutations were not shown growth PDGFRA wild-type Vanek’s tumor.


Download data is not yet available.
Abstract 296 | PDF Downloads 68


[1] Vanek, J. Gastric submucosal granuloma with eosinophilic infiltration. Am. J. Pathol. 1949, 25(3), 397-411.
[2] Helwig, E.B.; Ranier, A. Inflammatory fibroid polyps of the stomach. Surg. Gynecol. Obstet. 1953, 96, 335-367.
[3] Barussaud, M.; Regenet, N.; Briennon, X.; de Kerviler, B.; Pessaux, P.; Kohneh-Sharhi, N.; et al. Clinical Spectrum and Surgical Approach of Adult Intussusceptions: A Multicentric Study. Int. J. Colorectal Dis. 2006, 21(8), 834-839.
[4] Nishiyama, Y.; Koyama, S.; Andoh, A.; Kishi, Y.; Yoshikawa, K.; Ishizuka, I.; et al. Gastric inflammatory fibroid polyp treated with Helicobacter pylori eradication therapy. Intern. Med. 2003, 42, 263-267.
[5] Shalom, A.; Wasserman, I.; Segal, M.; Orda R. Inflammatory fibroid polyp and Helicobacter pylori. Aetiology or coincidence? Eur. J. Surg. 2000, 166, 54-57.
[6] Hirasaki, S.; Matsubara, M.; Ikeda, F.; Taniguchi, H.; Suzuki, S. Gastric Inflammatory Fibroid Polyp Treated with Helicobacter pylori Eradication Therapy. Intern. Med. 2007,46(12), 855-858.
[7] Agaimy, A.; Mudter, J.; Märkl, B.; Chetty, R. Cytomegalovirus infection presenting as isolated inflammatory polyps of the gastrointestinal tract. Pathology. 2011, 43(5), 440-446.
[8] Liu, T.C.; Lin, M.T.; Montgomery, E.A.; Singhi, A.D. Inflammatory fibroid polyps of the gastrointestinal tract: spectrum of clinical, morphologyc and immunohistochemistry features. Am. J. Surg. Pathol. 2013, 37, 586592.
[9] Jukic, Z.; Ferencic, Z.; Radulovic, P.; Mijic, A.; Fucic, A. Estrogen and androgen receptors in inflammatory fibroid polyp (Vanek's tumor): case report. Anticancer Res. 2014, 34(12), 7203-7206.
[10] Paikos, D.; Moschos, J.; Tzilves, D.; Koulaouzidis, A.; Kouklakis, G.; Patakiouta, F.; et al. Inflammatory fibroid polyp or Vanek's tumour. Dig. Surg. 2007, 24(3), 231-233.
[11] Wysocki, A.P.; Taylor, G.; Windsor, J.A. Inflammatory fibroid polyps of the duodenum: a review of the literature. Dig. Surg. 2007, 24(3), 162-168.
[12] Chongsrisawat, V.; Yimyeam, P.; Wisedopas, N.; Viravaidya, D.; Poovorawan, Y. Unusual manifestations of gastric inflammatory fibroid polyp in a child. World J. Gastroenterol. 2004, 10, 460–462.
[13] Siminas, S.; Qasem, E.; Shukla, R.; Turnock, R. Inflammatory Fibroid Polyp: A Rare Benign Tumor of the Alimentary Tract in Children Presenting As Intussusception—Case Report and Review of Literature. European J. Pediatr. Surg. Rep. 2014, 2(1), 16-19.
[14] Righetti, L.; Parolini, F.; Cengia, P.; Boroni, G.; Cheli, M.; Sonzogni, A.; et al. Inflammatory fibroid polyps in children: A new case report and a systematic review of the pediatric literature. World J. Clin. Pediatr. 2015, 4(4), 160-166.
[15] Blackshaw, A.J.; Levison, D.A. Eosinophilic infiltrates of the gastrointestinal tract. J. Clin. Pathol. 1986, 39, 1-7.
[16] Neishaboori, H.; Maleki, I.; Emadian, O. Jejunal intussusception caused by a huge Vanek’s tumor: a case report. Gastroenterol. Hepatol. Bed. Bench. 2013, 6, 210-213.
[17] Daum, O.; Hatlova, J.; Mandys, V.; Grossman, P.; Mukensnabl, P.; Benes, Z.; et al. Comparison of morphological, immunohistochemical, and molecular genetic features of inflammatory fibroid polyps (Vanek’s tumor). Virchows Arch. 2010, 456, 491-497
[18] Hasegawa, T.; Yang, P.; Kagawa, N.; Hirose, T.; Sano, T. CD34 expression by inflammatory fibroid polyps of the stomach. Mod. Pathol. 1997, 10, 451-456
[19] De Petris, G.; Leung, S.T. Pseudoneoplasms of the gastrointestinal tract. Arch. Pathol. Lab. Med. 2010, 134, 378-391.
[20] Kim, Y.I.; Kim, W.H. Inflammatory fibroid polyps of the gastrointestinal tract. Evolution of histologic patterns. Am. J. Clin. Pathol. 1988, 89, 721-727. doi: 10.1093/ajcp/89.6.721.
[21] Pantanowitz, L.; Antonioli, D.A.; Pinkus, G.S.; Shahsafaei, A.; Odze, R.D. Inflammatory fibroid polyps of the gastrointestinal tract: evidence for a dendritic cell origin. Am. J. Surg. Pathol. 2004, 28(1), 107-114.
[22] Montgomery, A.E.; Voltaggio, L. Biopsy Interpretation of the Gastrointestinal Tract Mucosa. Volume 2: Neoplastic 3rd Edition; 2018.
[23] Kolodziejczyk, P.; Yao, T.; Tsuneyoshi, M. Inflammatory fibroid polyp of the stomach. A special reference to an immunohistochemical profile of 42 cases. Am. J. Surg. Pathol. 1993, 17(11), 1159-1168.
[24] Montgomery, E.A.; Meis, J.M. Nodular fasciitis. Its morphologic spectrum and immunohistochemical profile. Am. J. Surg. Pathol. 1991, 15, 942-948
[25] Mucientes, P.; Mucientes, F.; Klaassen, R. Inflammatory fibroid polyp associated with early gastric carcinoma: a case report. Ann. Diagn. Pathol. 2012, 16(2), 148-151.
[26] Schildhaus, H.U.; Cavlar, T.; Binot, E.; Büttner, R.; Wardelmann, E.; Merkelbach-Bruse, S. Inflammatory fibroid polyps harbour mutations in the platelet-derived growth factor receptor alpha (PDGFRA) gene. J. Pathol. 2008, 216(2), 176-182.
[27] Huss, S.; Wardelmann, E.; Goltz, D.; Binot, E.; Hartmann, W.; Merkelbach-Bruse, S.; et al. Activating PDGFRA mutations in inflammatory fibroid polyps occur in exons 12, 14 and 18 and are associated with tumour localization. Histopathology. 2012, 61, 59-68.

Most read articles by the same author(s)