Chronic Ménétrier disease leading to gastric cancer in youth

Abstract

Ménétrier disease (MD) is a rare, acquired gastric hyperproliferative disorder characterized by enlarged gastric folds, hypoalbuminemia, and reduced acid production. 1 Histological hallmarks include a massive expansion of surface mucous cells (foveolar hyperplasia) and glandular atrophy. 2 Adults and children have different etiologies, clinical manifestations, and outcomes. It is a chronic condition in adulthood with a risk of neoplastic transformation of up to 9% after 10 years of diagnosis. 3 During childhood, it is considered an acute, self-limiting condition, with an average disease duration of 2 weeks. 4 Pathogenesis is still unclear, which might limit the management of patients suffering from this condition.This article reports the first case in the literature of chronic pediatric MD leading to gastric cancer. A previously healthy 10-year-old girl presented with vomiting, sporadic melena, and weight loss (10% of body weight) over one month. A physical examination revealed pallor and mild edema. Laboratory studies demonstrated anemia (hemoglobin [Hb], 5.0 g/dL), hypoalbuminemia (3.4 mg/dL), and an elevated serum gastrin level (350 pg/mL). Esophagogastroduodenoscopy (EGD) revealed