inflammatory fibroid polyps ( ifps ) occur throughout the gastrointestinal tract but are usually seen in the colon , where they accompany a variety of inflammatory disorders , and are often difficult to diagnose by biopsy [ 1 , 2 , 3 , 4 ] . gastric ifps usually occur in the antrum or prepyloric region and may be a source of bleeding or outlet obstruction . we report a case of gastric ifp in which the lesion showed marked changes in morphological features and size within a short period of time ; the diagnosis was made by endoscopic submucosal dissection ( esd ) . a 64-year - old man had been under regular endoscopic follow - up because of a gastric submucosal tumor in the anterior wall of the gastric antrum ; examination of biopsy specimens had revealed normal mucosa . the lesion , which had been 15 mm in diameter in 2002 , showed no change in size or shape at the first 4-year follow - up . however , in 2007 , it was found to have developed two humps and to have increased in diameter to 25 mm ( fig . 1 ) . there were no specific physical findings , and hematological and biochemical examinations were within normal limits . endoscopic ultrasonography showed a homogeneous hypoechoic lesion measuring 20 mm in diameter within the second layer of the gastric wall ( fig . esd was performed with the patient 's consent , and the diagnosis of ifp was made on histopathological examination of the resected specimen ( fig . ifps are rare benign lesions that may occur at any of various sites in the gastrointestinal tract , but are most commonly encountered in the distal stomach and distal ileum . the final diagnosis of ifp depends on the pathological findings ; however , the histological findings of the biopsy specimen are often difficult to diagnose [ 4 , 6 ] . in this case it has been suggested that h. pylori may play a role in the pathophysiology of ifp , however , tests for h. pylori were negative in this case . ifp was strongly suspected based on the findings on endoscopic ultrasonography in this case , and the lesion was resected by esd . as gastric ifp is a benign tumor , it is seldom resected by endoscopic resection or surgery ; however , ifps are sometimes treated with endoscopic mucosal resection or esd if the tumor is accompanied by malignant lesion or is increasing in size . endoscopic resection of ifp is unnecessary unless there is a rapid increase in size or association with neoplasm ; however , careful observation is necessary in treating patients with gastric ifp . it is suggested that esd may be an effective and safe therapy for gastric submucosal tumors .
the endoscopic examination of a 64-year - old male patient revealed a gastric submucosal tumor in the anterior wall of the gastric antrum . 
 the lesion increased in diameter to 25 mm and was resected completely with endoscopic submucosal dissection ( esd ) . 
 histological examination of the submucosal tumor gave a diagnosis of an inflammatory fibroid polyp ( ifp ) . 
 it is suggested that esd may be an effective and safe therapy for gastric submucosal tumors .