Report of Two Cases of Gastric Cancer after Bariatric Surgery: Lymphoma of the Bypassed Stomach after Roux-en-Y Gastric Bypass and Gastrointestinal Stromal Tumor (GIST) after Vertical Banded Gastroplasty

Abstract

We report two new cases of gastric cancer diagnosed after a bariatric operation. The first case is a 66-year-old male who 3 years after gastric bypass suffered from a perforation of the fundus that was found to be secondary to a diffuse large B-cell lymphoma of the distal stomach. The second case is a 47-year-old woman who presented 12 years after a vertical banded gastroplasty with a gastric pouch outlet obstruction caused by a gastrointestinal stromal tumor (GIST). Based on the few reports of cancer in the literature, analysis of these cases suggests that the main risk of gastric cancer after bariatric surgery comes from the delayed diagnosis of malignancy.

Treatment of gastric gastrointestinal stromal tumor by laparoscopic sleeve gastrectomy in a morbidly obese patient

“…Several studies have reported that GIST-like pathologies may be detected during bariatric surgery procedures or postoperative histopathological examinations of the resected gastric specimen (4). A 57 years-old male patient was admitted to our clinics for a planned LSG due to morbid obesity.…”

Risk of Upper Gastrointestinal Cancer after Bariatric Operations

“…This is shown in the following case report: 23 A 47-year-old lady presented in our clinic after several months of progressive dysphagia with vomiting, 12 years after a VBG. These symptoms had been attributed to inadequate respect for dietetic rules after VBG.…”

“…22 The delay in diagnosis of cancer represents a risk for lesions arising in the excluded distal stomach that are more difficult to investigate. This is illustrated in the following case referred to our surgical department: 23 A 66-yearold male 3 years after RYGBP, was diagnosed with a gastric fundus perforation associated with a diffuse large B-cell lymphoma. The patient had a 6-month history of anemia with GI bleeds, with investigation by upper and lower endoscopy having been negative.…”

Laparoscopic Resectional Gastric Bypass in Patients with Morbid Obesity: Experience on 112 Consecutive Patients

“…[41][42][43][44][45][46][47][48] However, it is probably that other cases have not been reported. An experimental study suggested that Roux-en-Y gastric bypass reduces the risk of development of gastric cancer due to the lack of contact of with carcinogens' lower bile reflux and fewer bacterial in the proximal gastric pouch.…”