Comorbid gastric adenocarcinoma and gastric and duodenal Strongyloides stercoralis infection: a case report.
Strongyloides stercoralis can cause systemic infection, termed strongyloidiasis, and gastrointestinal ulcer disease in immunocompromised patients. However, to our knowledge, there are no reported cases of comorbid gastric adenocarcinoma and S. stercoralis infection. Here, we report a case of an 81-year-old Korean man who presented with S. stercoralis infection coexisting with early gastric adenocarcinoma (T1aN0M0). S. stercoralis eggs, rhabditiform larvae, and adult females were observed in normal gastric and duodenal crypts. They were also observed in atypical glands representative of adenocarcinoma and adenoma. Preliminary laboratory tests revealed mild neutrophilic and eosinophilic leukocytosis. A routine stool test failed to detect rhabditiform larvae in the patient's fecal sample; however, S. stercoralis was identified by PCR amplification and 18S rRNA sequencing using genomic DNA extracted from formalin-fixed paraffin-embedded tissues. Postoperatively, the patient had a persistent fever and was treated with albendazole for 7 days, which alleviated the fever. The patient was followed-up by monitoring and laboratory testing for 4 months postoperatively, and no abnormalities were observed thus far. The fact that S. stercoralis infection may be fatal in immunocompromised patients should be kept in mind when assessing high-risk patients.
Department of Pathology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Deagu 700-721, Korea.
An Na
AN
Seo
Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Deagu 700-721, Korea.
Youn-Kyoung
YK
Goo
Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Deagu 700-721, Korea.
Dong-Il
DI
Chung
Department of Parasitology and Tropical Medicine, Kyungpook National University School of Medicine, Daegu, Deagu 700-721, Korea.
Yeonchul
Y
Hong
Gastric Cancer Center, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Deagu 700-721, Korea.
Ohkyoung
O
Kwon
Department of Pathology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Deagu 700-721, Korea.
Han-Ik
HI
Bae
D000230:Adenocarcinoma / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D000369:Aged, 80 and over; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D018509:DNA, Helminth / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D016145:Endoscopy, Digestive System; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007723:Korea; D008297:Male; D012337:RNA, Ribosomal, 18S / Q000235:genetics; D017422:Sequence Analysis, DNA; D013274:Stomach Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D017171:Strongyloides stercoralis / Q000302:isolation & purification*; D013322:Strongyloidiasis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D016896:Treatment Outcome
D000871:Anthelmintics; D018509:DNA, Helminth; D004275:DNA, Ribosomal; D012337:RNA, Ribosomal, 18S; D015766:Albendazole
PCR; Strongyloides stercoralis; formalin-fixed paraffin-embedded tissue; gastric adenocarcinoma