Published online Feb 7, 2022. doi: 10.3748/wjg.v28.i5.594
Peer-review started: October 2, 2021
First decision: November 7, 2021
Revised: December 3, 2021
Accepted: January 19, 2022
Article in press: January 19, 2022
Published online: February 7, 2022
Adult-onset Ménétrier’s disease is strongly associated with Helicobacter pylori (H. pylori) infection and an elevated risk of carcinogenesis. Cases of early-stage gastric cancer developed in H. pylori-negative Ménétrier’s disease are extremely rare. We report a case of early gastric cancer in H. pylori-negative Ménétrier’s disease that was curatively resected with endoscopic submucosal dissection (ESD).
A 60-year-old woman was referred to our hospital after her medical examination detected anemia. Contrast-enhanced upper gastrointestinal (UGI) radiography revealed translucency of the nodule-aggregating surface with giant rugae. Blood tests showed hypoproteinemia and were negative for serum H. pylori immunoglobulin G antibodies. The 99mTc-DTPA-human serum albumin scintigraphy showed protein loss from the stomach. UGI endoscopy showed a 40-mm protruding erythematous lesion on giant rugae of the greater curvature of lower gastric body, suggesting early-stage gastric cancer due to Ménétrier’s disease. En bloc resection with ESD was performed for diagnosis and treatment. Histology of ESD showed well-differentiated tubular adenocarcinoma. The cancer was confined to the mucosa, and complete curative resection was achieved. Foveolar hyperplasia and atrophy of the gastric glands were observed in non-tumor areas, histologically corresponding to Ménétrier’s disease. Three years after ESD, gastric cancer had not recurred, and Ménétrier’s disease remained in remission with spontaneous regression of giant gastric rugae.
Complete curative resection was achieved through ESD in a patient with early-stage gastric cancer and H. pylori-negative Ménétrier’s disease.
Core Tip: We reported an extremely rare case of gastric cancer as a complication of Helicobacter pylori-negative Ménétrier’s disease. The cancer was early-stage, and a minimally invasive curative resection was achieved with endoscopic submucosal dissection (ESD). There was no recurrence, and the patient’s course was extremely good. This case also highlights that when endoscopic biopsy tissue from a cancer-suspected lesion showed atypical glands in Ménétrier’s disease, total biopsy with ESD can be useful for diagnosis as well as treatment. ESD seems to be a beneficial therapy for early-stage gastric cancer in Ménétrier’s disease because of its low invasiveness and high complete curative resection rate.