Gastritis cystica profunda: Case report of an uncommon condition and a brief review of the literature

Gastritis cystica profunda (GCP) is a relatively uncommon benign disease characterized by cystic dilatation and submucosal herniation of the gastric glands. Its clinical and radiological features tend to simulate gastric malignancy, rendering a serious diagnostic dilemma. We describe a GCP case that highlights the diagnostic challenges and underscores the importance of multidisciplinary approach to establish a definitive diagnosis.

A 51-year-old man with a history of gastric polypectomy reported with chronic abdominal pain, early satiety, and unintentional loss of weight. His family history was positive for gastric adenocarcinoma. Endoscopy showed that there is an umbilicated nodular lesion with an umbilication in the center of the site of previous polypectomy. Endoscopic ultrasound revealed a submucosal mass of cystic spaces, hypoechoic, and without ruling out malignancy. A multidisciplinary tumor board suggested surgical resection. The patient underwent a laparoscopic wedge resection. The resected specimen, pathologically examined, revealed a diagnosis of GCP, characterized by hyperplastic glands with cystic dilatation extending into the submucosa, but without evidence of dysplasia or malignancy. The patient's postoperative course was uneventful, with full recovery of symptoms and no recurrence during the three-year follow-up.

The differential diagnosis of gastric submucosal tumors should include GCP when gastric surgery or instrumentation is present. The characteristic of malignancy mimicry makes it challenging to rule out infections requiring full-thickness surgical excision completely, necessitating a definitive diagnosis in many instances. Total resection is diagnostic and curative, and the prognosis is excellent.