Eosinophilic gastroenteritis associated with multiple gastric cancer

Abstract

Eosinophilic gastroenteritis (EG) is an inflammation of the digestive tract that is characterized by eosinophilic infiltration. There are no specific symptoms, and are related to the layer in which eosinophilic infiltration is observed. A 69-year-old Japanese man presented to our hospital with a history of general malaise, diarrhea, and dysgeusia. Esophagogastroduodenoscopy showed reddish elevated lesions that were edematous all over the gastric mucosa. In addition, three tumors were also observed. The biopsies of the reddish elevated mucosa revealed eosinophilic infiltration and tubular adenocarcinoma from the tumors. Colonoscopy showed abnormal reddish elevated mucosa. The biopsies from the reddish elevated mucosa showed eosinophilic infiltration. From the abdominal contrast computed tomography scan, tumor stain was seen in the anterior wall of the gastric body. No ascites, intestinal wall thickening, or lymph node swelling were found. A slight elevation in the serum immunoglobulin E (IgE), 480 IU/ml, was found from the laboratory test results; other laboratory results were within normal limits including the number of peripheral eosinophils. No specific allergen was found from the multiple antigen simultaneous test and from the skin patch test. The parasitic immunodiagnosis was negative. He was diagnosed with EG associated with gastric cancer and underwent total gastrectomy, regional lymph node dissection with reconstruction by a Roux-en-Y method. He was prescribed prednisolone after the operation and showed a good clinical response. There are many case reports on EG, but none of them were associated with cancer. We encountered a case of EG associated with multiple gastric cancer; the patient underwent total gastrectomy.

Eosinophilic Gastroenteritis in the Small Intestine Mimicking Eosinophilic Granulomatosis With Polyangiitis in a Young Male Patient

“…Chronic changes in the lumen of the gastrointestinal tract can cause various complications such as chronic constipation, diarrhea, and abdominal pain [3]. Inflammation in the GI tract due to EGE or EGPA can lead to cancer, as other inflammatory gastrointestinal diseases such as Crohn's disease and ulcerative colitis [11,12]. Physicians may focus on the present symptoms and treatments while patients may insist on the present symptoms without a previous chronic clinical course.…”

Eosinophilic peritonitis with colon cancer: a case report

“…Among such rare diseases, few cases of EGIDs with malignant or benign tumors have been reported. In a literature search using PubMed for articles containing the keywords “eosinophilic enteritis” AND “tumor” OR “cancer” OR “malignancy”, it was found that, to date, there have been only five reported cases of EGIDs with malignant or benign tumors in the world, including the present case (Table 1 ) [ 2 – 5 ]. Of the five reported cases, three were the predominant mucosal type.…”

“…More similar cases are needed to obtain unknown pathological factors of eosinophilia in malignant tumors. In summary, given that the patient had no history of allergy, the actual eosinophilic distributions, and the unique clinical course, the present case may suggest the possibility of an association between eosinophilic peritonitis and colon cancer [ 2 – 4 , 18 ].…”

“…In this group, eosinophilic esophagitis is the most common, and eosinophilic gastroenteritis and colitis are rarer [ 1 ]. Of them, EGIDs with malignant or benign tumors are extremely rare, with only four cases reported worldwide [ 2 – 5 ]. A case of colon cancer with massive ascites due to eosinophilic peritonitis, one subtype of the EGIDs, is presented.…”

Carcinoma Colon in a Patient with Eosinophilic Gastroenteritis

“…Despite being remitting relapsing inflammatory disease EG, there is only one case report of association of EG with gastric cancer. [7] We report a case of EG leading to adenocarcinoma colon. This is the first case report suggesting an association between EG and adenocarcinoma of colon.…”