Inflammatory fibroid polyp (Vanek's tumor) of the gastric antrum: is treatment always mandatory?

INTRODUCTION: Inflammatory fibroid polyp (IFP), also known as Vanek's tumor, is a rare polypoid lesion of the gastrointestinal tract. A recently observed case led us to review the literature, with the aim to discuss the management of asymptomatic gastric IFPs. CASE REPORT: A 71-year-old man was endoscopically diagnosed as having a polypoid lesion located in the gastric antrum. Histopathological and himmunoistochemical studies of endoscopic biopsies revealed an IFP. Endoscopic resection was proposed, but the patient refused such a treatment because he was asymptomatic for his polyp. After three years the patient is asymptomatic and the endoscopic surveillance follow-up has showed no evidence of growth nor other modifications of the gastric IFP. DISCUSSION: Gastric IFPs are benign polyps of unknown etiology which sometimes pose problems of differential diagnosis with GISTs, and various mesenchymal tumors. Although gastric IFPs are benign lesions usually asymptomatic, most of the cases reported in the literature have been treated by endoscopic or surgical excision. In the case described herein, no modifications of the polyp were observed at endoscopic follow-up. CONCLUSION: This case description suggests that removal of gastric IFPs, either by endoscopic or surgical approach, may not be mandatory in asymptomatic patients.