Table 1.
|
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Frequency
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Risk factors
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Associated conditions
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Age/sex
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Location
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Size
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Symptoms
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Endoscopic features
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Neoplastic potential
|
Good | ||||||||||
Fundic gland | Sporadic | 80% | Proton-pump inhibitors | None | Middle age/women | Body/fundus | < 8 mm | Asymptomatic | Sessile, smooth surface | Very rare |
Syndromic | Hereditary | Familial adenomatous polyposis, MUTHY | Early age/no sex difference | Body, multiple (> 90%) | < 6 mm | Asymptomatic | Rare | |||
Inflammatory fibroid | Rare (< 0.1%) | Not known |
May be familial, Devon polyposis syndrome-associated with PDGFRA mutation | Older (6th-7th decade) (adults/slight predominace in women) | Antrum-pylorus | Mean size 1-5 cm, up to 9 cm | Early satiety or good, sometimes bleeding | Sessile, pedunculated, +/- ulcerated | Very rare | |
Ectopic pancreas | 0.5%-13% | None | None | Not reported | Antrum-prepyloric region | Variable | Incidental | Firm round or oval subepithelial lesion with a central depression | Benign, no follow-up needed | |
Hamartomatous polyp | Sporadic | 1% | Not known | - | Not reported | Anywhere | Variable | Incidental findings | Sessile, differential dx H. pylori | Benign |
Bad | ||||||||||
Hamartomatous | Syndromic | PJS, Juvenile polyposis syndrome and phosphatase and tensin homolog hamartoma syndrome | STK11 (PJS) | - | - | The 0.1-3 cm (PJS) | - | Lifetime malignancy risk (up to 29%) | ||
Hamartomatous | Solitary | Gastric inverted Hamartomatous Polyps | Common (up to 20%) | |||||||
Hyperplastic | 15% | H. pylori, chronic atrophic gastritis | Not reported | Middle age/no sex difference | Antrum (60%), any site, solitary, more common multiple | Usually < 2 cm, but up to 12 cm | Asymptomatic, incidental findings | Smooth or lobulated, sessile or pedunculated | Dysplasia 15%, cancer risk < 1% | |
Adenoma | 6%-10% | Atrophy, intestinal Metaplasia | None | Middle age/men (intestinal type) | More common, antrum (intestinal type), any site (other types) | Variable (few mm to cm) | Asymptomatic, anemia, bleeding, rarely obstruction | Sessile, pedunculated | Depends on size; histology (high-grade dysplasia 30% at 5 years); likely gene-disrupting 3% at 5 years | |
Gastric neuroendocrine tumors | < 2% gastric neoplasm | |||||||||
GNET type 1 | 80% all G-NET | Autoimmune gastritis | None | Middle age/old | Body, fundus | Small, multiple | Asymptomatic anemia | Reddish | Low (< 1%), locoregional MTS depends on size, grading and mm propria invasion: 5 years survival 100% | |
GNET type 2 | 5% | Gastrinoma (multiple endocrine neoplasia type 1) | Young | Body, fundus | Small, multiple | Diarrhea, abdominal pain bleeding from peptic ulcer |
Small, yellow, often multiple ulceration | Lymph node MTS 30% with good prognosis | ||
Ugly | ||||||||||
GNET type 3 | The 10%-20% all GNET | No predisposing factors | None | Adults/no sex difference | Anywhere, preference antrum | Large, solitary | Asymptomatic | Single lesion | The 50% risk MTS. Survival 70% at 5 years | |
Early gastric cancer | Sporadic hereditary (1%-3%) |
Equal to gastric adenomaE-cadherin gene | None | Adult/old/male | Antrum (50%) corpus (35%), cardia (15%) | Epigastric pain glycemic index bleeding, anemia, vomiting/nausea | Polyp, ulcer | The 5 years survival 75%, the 80% lifetime cancer risk |
GNET: Gastro-intestinal neuroectodermal tumor; PJS: Peutz-Jeghers syndrome; H. pylori: Helicobacter pylori; MTS: Metastasis.