Gastric cancer associated with refractory cytomegalovirus gastritis

Clin J Gastroenterol. 2017 Dec;10(6):498-502. doi: 10.1007/s12328-017-0773-9. Epub 2017 Sep 7.

Abstract

Cytomegalovirus (CMV) sometimes causes gastritis, especially in immunocompromised patients, but whether CMV gastritis promotes the development of gastric cancer is unknown. Here, we report a case of gastric cancer that developed in the presence of CMV gastritis, which had been present for at least 4 years and was refractory to treatment. An 80-year-old woman had noted epigastric discomfort and appetite loss. Esophagogastroduodenoscopy revealed a shallow geographical ulcer extending from the upper body to the pylorus. Histological findings of the biopsy and serology were suggestive of CMV gastritis. Serum anti-Helicobacter pylori antibody test was positive, suggesting co-infection with CMV and H. pylori. Her gastritis was unimproved with repeated antiviral therapy and eradication of H. pylori. Thirty months later, wide-spread gastric cancer had developed. We suggest the possibility that the addition of chronic inflammation of CMV infection to H. pylori-induced gastritis facilitated the development of gastric cancer.

Keywords: Cytomegalovirus; Endoscopy; Gastric cancer; Gastritis; Helicobacter pylori.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications*
  • Adenocarcinoma / microbiology
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Coinfection
  • Cytomegalovirus Infections / complications*
  • Cytomegalovirus Infections / drug therapy
  • Endoscopy, Digestive System
  • Female
  • Ganciclovir / therapeutic use
  • Gastritis / complications*
  • Gastritis / drug therapy
  • Gastritis / microbiology
  • Helicobacter Infections / complications*
  • Helicobacter Infections / drug therapy
  • Humans
  • Stomach Neoplasms / complications*
  • Stomach Neoplasms / microbiology
  • Treatment Failure

Substances

  • Antiviral Agents
  • Ganciclovir