HIV-associated early gastric adenocarcinoma successfully cured with surgery, and followed over eight years.
An extremely rare case report of HIV-associated gastric adenocarcinoma surgically treated in the year 1998 in a 37-year-old male patient already HIV positive for 10 years, with a complete post-surgery disease-free follow-up of eight years, is described. An international literature search allowed us to report the available details of the only nine cases of HIV-associated gastric cancer yet published. Seven occurred prior to the introduction of highly active antiretroviral therapy (HAART) and were burdened by a rapid disease evolution, while only two patients were reported after the introduction of HAART (like ours) and obtained surgical cure. Detailed data regarding complications, sequelae and overall survival are not given. Notably, even four of the nine published reports came from Japan, and an early disease development was usual (37-50 years of age at diagnosis). Due to its relevant differential diagnosis implications with many other HIV-related gastrointestinal disturbances caused by functional and organic diseases (drug-related disturbances, HIV infection itself, opportunistic infections, and Kaposi's sarcoma and malignant lymphomas being the most frequent disorders) and the possibility of maintaining an adequate life-expectancy when diagnosis and aggressive treatment are not delayed, gastric cancer should be considered carefully by all clinicians dealing with HIV disease.
Manfredi
Roberto
R
Division of Infectious Diseases, Department of Clinical and Experimental Medicine, 'Alma Mater Studiorum' University of Bologna, S Orsola-Malpighi Hospital, Bologna, Italy. roberto.manfredi@unibo.it
Sabbatani
Sergio
S
Fasulo
Giovanni
G
D000230:Adenocarcinoma / Q000601:surgery / Q000821:virology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D013274:Stomach Neoplasms / Q000601:surgery / Q000821:virology*; D017741:Survivors; D019562:Viral Load