Gastric Cancer After Helicobacter pylori Eradication for Nodular Gastritis in an Adolescent

Abstract

A 16-year-old girl underwent esophagogastroduodenoscopy (EGD) after the detection of Helicobacter pylori (H. pylori) antibodies in her urine during a school health screening, which revealed nodular gastritis (NG). She was diagnosed as having H. pylori infection histologically and by biopsy culture specimens and soon commenced eradication therapy. Eight weeks later, eradication was confirmed by a urea breath test. At the age of 19, however, she was referred to our hospital with epigastralgia and lower back pain. EGD revealed ulcerative lesions with enlarged folds at the greater curvature of the gastric body. Biopsy specimens of the lesions revealed poorly differentiated adenocarcinoma and signet ring cell carcinoma. The cancer was classified as stage IV with pancreatic invasion. Although NG with pangastritis is considered a high-risk factor for diffuse-type gastric carcinoma, the course of NG after eradication remains unknown. Careful histological assessment before eradication by endoscopic biopsy and close follow-up after eradication are therefore recommended, even in young patients.

Rights and wrongs of Helicobacter pylori testing and treatment in children

“…However, it is a known fact that gastric cancer occurs even in teens, and it may lead to unfortunate consequences. 8 Pediatricians are not only responsible for keeping children healthy during childhood but also need to be responsible for keeping children healthy as adults. Even if there are few H. pylori -related diseases in childhood, it is also necessary to take early measures to prevent problems in adulthood.…”