Xanthogranulomatous gastritis of the remnant stomach mimicking a malignant tumor: A case report

Abstract

Abstract. Xanthogranulomas are known to develop in the gallbladder and kidney. Xanthogranuloma of the stomach is a rare disease, and to the best of our knowledge, only a few cases have been reported to date. The present patient was a 64-year-old man who underwent a wide resection of the stomach following a Billroth-I reconstruction for a gastric ulcer ~40 years prior to the current presentation. Due to tarry stools, a gastrointestinal endoscopy was performed, leading to identification of an ulcerated gastric lesion located at the previous suture line at the lesser curvature of the remnant stomach. This lesion was elevated, appearing to indicate a submucosal tumor. Positron emission tomography revealed uptake of fluorodeoxyglucose radiotracer by the tumor. Although not indicated by the biopsy specimens, a malignant tumor of the remnant stomach was suspected, in the form of a malignant gastrointestinal tumor or remnant gastric cancer. Curative resection of the tumor was successfully performed. Histological examination of the resected specimens revealed xanthogranulomatous inflammation consisting of foamy histiocytes and plasma cells, however, no cancer cells were observed. The tumor was diagnosed as xanthogranulomatous gastritis that mimicked a malignant tumor of the remnant stomach. The present study therefore indicates that inflammatory tumors should be considered in the differential diagnosis of malignant tumors.

Endoscopic Resection of Xanthogranulomatous Gastritis Presenting as a Subepithelial Tumor: A Case Report

“…Another 8 cases were diagnosed as SETs, [7][8][9][10][12][13][14] including 3 cases of suspected GIST.…”

“…Three cases underwent total gastrectomy, 3,7,11 4 cases did distal gastrectomy, 5,9,10,13 3 cases did partial gastrectomy, 4,8,12 1 case did subtotal gastrectomy, 6 and 1 case did Roux-en-Y. 14 In addition, 6 cases involved comorbidities: 2 cases of early gastric cancer (EGC), 9,11 2 cases of gastric ulcer perforation, 7,10 1 case of xanthogranulomatous cholecystitis (XGC), 5 and 1 case of actinomycosis. 13 Trace history involving 7 patients for more than 1 year showed no recurrence.…”

“…In the case of stomach, reports of xanthogranulomatous gastritis (XGG), which is a type of subepithelial tumor (SET), are available internationally. [3][4][5][6][7][8][9][10][11][12][13][14] The XGG, is misdiagnosed as an advanced gastric cancer or gastrointestinal stromal tumor (GIST), and is diagnosed after partial or total gastric resection. [3][4][5][6]9,11,12,14 The incidence or fatality rate of XGG is unknown, and no optimal treatment has been found.…”

“…In the case of XGG, which accompanied bleeding or severe abdominal pain, were reported with the invasiveness of local tissue. [11][12][13][14] However, the invasiveness of XGG in asymptomatic patients has not been reported.…”

Neck xanthogranuloma mimicking malignancy in a patient with diabetes mellitus

“…Xanthogranulomatous inflammation (XGI) is an uncommon inflammatory condition initially described by Oberling as a benign lesion in retroperitoneal organs. [ 1 , 2 ] Pathogenesis of XGI remains largely unknown, with current proposed hypotheses including defective lipid metabolism, disruption of immune response, mechanic lymphatic obstruction, and inherited lysosomal disorders. [ 3 ] Definite diagnosis relies on ultimate pathologic analysis because clinical and imaging information are usually nonspecific.…”