Published online Jun 14, 2017. doi: 10.3748/wjg.v23.i22.4127
Peer-review started: January 12, 2017
First decision: March 3, 2017
Revised: March 14, 2017
Accepted: April 12, 2017
Article in press: April 12, 2017
Published online: June 14, 2017
Processing time: 155 Days and 0.4 Hours
We present a case of a 56-year-old man with 3 synchronous gastric tumors. The patient presented with melena, and 3 gastric abnormalities were detected on gastroduodenoscopic examination, including a small ulcerative lesion in the gastric antrum, a submucosal mass in the gastric body, and severe erosion in the fundus. Histological examination of biopsy samples yielded respective diagnoses of gastric adenocarcinoma, gastritis, and mucosa-associated lymphoid tissue (MALT) lymphoma. The patient first received medication to eradicate any underlying Helicobacter pylori infection, which might have been a cause of the MALT lymphoma. Four weeks later, after examination of repeat biopsy samples revealed that the MALT lymphoma had resolved, the patient underwent subtotal gastrectomy. Further histological examination of resected tissue confirmed the antrum lesion as adenocarcinoma and the body lesion as schwannoma. To our knowledge, this is the first reported case of synchronous triple primary gastric adenocarcinoma, MALT lymphoma, and schwannoma.
Core tip: Synchronous occurrence of two types of gastric tumor is relatively well described, but this is the first report of synchronous triple gastric adenocarcinoma, mucosa-associated lymphoid tissue (MALT) lymphoma, and schwannoma. Consideration of the possible underlying involvement of Helicobacter pylori in MALT lymphoma and preoperative treatment with appropriate medication allowed performance of subtotal gastrectomy and a successful outcome.