Published online Mar 28, 2014. doi: 10.3748/wjg.v20.i12.3388
Revised: January 13, 2014
Accepted: February 20, 2014
Published online: March 28, 2014
Fishbones are the most commonly ingested foreign bodies that cause gastrointestinal tract penetration. However, fishbones embedded in the gastrointestinal tract that lead to foreign body granulomas that mimic submucosal tumors are rare. Herein, we describe a 56-year-old woman who presented with a 20-day-history of upper abdominal pain. Endoscopy revealed an elevated lesion in the gastric antrum. An abdominal computed tomography scan showed a mass in the gastric antrum and a linear calcified lesion in the mass. An endoscopic ultrasonography examination revealed a 3.9 cm × 2.2 cm, irregular, hypoechoic mass with indistinct margins in the muscularis propria layer. The patient was initially diagnosed as having a submucosal tumor, and subsequent surgical resection showed that the lesion was a foreign body granuloma caused by an embedded fishbone. Our case indicated that the differential diagnosis of a foreign body granuloma should be considered in cases of elevated lesions in the gastrointestinal tract.
Core tip: Gastric foreign body granulomas caused by embedded fishbones that mimic submucosal tumors are rare. A gastric intestinal stromal tumor, gastric leiomyoma, and gastric neurofibroma should be considered as differential diagnoses. A computed tomography scan is the most sensitive diagnostic choice, and endoscopic ultrasonography can also be helpful for diagnosis.