Curative resection with endoscopic submucosal dissection of early gastric cancer in Helicobacter pylori-negative Menetrier's disease: A case report

BACKGROUND Adult-onset Menetrier's disease is strongly associated with Helicobacter pylori (H. pylon) infection and an elevated risk of carcinogenesis. Cases of early-stage gastric cancer developed in H. pylori-negative Menetrier's disease are extremely rare. We report a case of early gastric cancer in H. pylori-negative Menetrier's disease that was curatively resected with endoscopic submucosal dissection (ESD). CASE SUMMARY 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 Tc-99m-DIPA-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 Menetrier'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 Menetrier's disease. Three years after ESD, gastric cancer had not recurred, and Menetrier's disease remained in remission with spontaneous regression of giant gastric rugae. CONCLUSION Complete curative resection was achieved through ESD in a patient with early- stage gastric cancer and H. pylori-negative Menetrier's disease.

Automated summary

We report a case of early gastric cancer in H.pylori-negative Menetrier's disease that was curatively resected with endoscopic submucosal dissection (ESD).