Multiple synchronous adenocarcinoma arising in a background of mixed hyperplastic/adenomatous polyp in a young female: A case report with review of literature

Gastric hyperplastic polyps (HPPs) are typically regarded as benign lesions, though there have been occasional reports of adenocarcinoma arising in these lesions. The exact mechanism of carcinogenesis in gastric HPPs remains unclear, but most malignant polyps are thought to arise from the dysplastic epithelium rather than a hyperplastic epithelium. Herein, we report a case depicting the morphological continuum of adenocarcinoma sequence and with presence of multiple synchronous adenocarcinomas arising in the background of mixed hyperplastic/adenomatous polyp in conjunct with the brief review of literature in a 28-year-old female, who presented with abdominal cramping and anemia. On endoscopy, two polyps were identified, underwent polypectomy, followed by radical gastrectomy. On pathological examination, these gastric polyps showed features of adenoma with foci of invasive adenocarcinoma with lymph node metastasis and further molecular characterization was done.