Low Grade MALToma and Early Cancer of the Stomach in a Patient with Helicobacter pylori Infection: A Case Report

Abstract

A causal relationship has been suggested between Helicobacter pylori infection and gastric malignancy, including both gastric cancer and low grade lymphoma of mucosa‐associated lymphoid tissue (MALToma). We describe a rare case of simultaneous occurrence of low grade MALToma and early cancer of the stomach in a 72‐year‐old woman. In this patient, low grade MALToma not only had preceded gastric cancer by 5 years, but had also disappeared, and subsequently reappeared coexisting with early cancer of the stomach and Helicobacter pylori infection. Eradication therapy for Helicobacter pylori was performed immediately prior to subtotal gastrectomy for early gastric cancer of the pyloric area. Thereafter, regression of MALToma was observed. These results, taken together with a previously reported case of low grade MALToma, suggest that low grade MALToma of the stomach may fluctuate, at least in the initial stages, even in the presence of constant Helicobacter pylori infection.

Simultaneous early adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach associated with Helicobacter pylori infection

“…In Japan, total gastrectomy has been routinely performed. Although a total gastrectomy was performed in our patient for the treatment of gastric cancer, a combination of a partial gastrectomy and antibiotic therapy might be an alternative choice for the treatment of these double malignancies, because recent reports have suggested that low-grade MALT lymphomas may regress after the eradication of H. pylori [11][12][13]. However, in patients treated with the combination of a partial gastrectomy and H. pylori eradication therapy, periodic surveillance endoscopies are required, because it remains unclear whether the neoplastic clone is eliminated or merely suppressed.…”

“…MALT lymphoma have been previously reported in the English-or Japanese-language literature [9][10][11][12][13][14].…”