Inflammatory fibroid polyp (IFP) is a rare mesenchymal lesion of the gastrointestinal tract. The association of IFP with gastric carcinoma has been only reported in 7 previously published cases. We present the case of a 69-year-old man who underwent gastrectomy because of an early gastric carcinoma invading the submucosa with an underlying IFP, which pushed the neoplastic surface to the gastric lumen in a polypoid fashion. The IFP revealed a CD34-positive spindle cell proliferation surrounding blood vessels in a concentric way and covered by carcinomatous glands. The patient is free of disease after 108 months of follow-up. The underlying spindle cell proliferation and blood vessels may be reactive to malignant glands found in the surface, although recent molecular analyses support the neoplastic nature of this lesion. (C) 2012 Elsevier Inc. All rights reserved.