Xanthogranuloma refers to a tumor with multiple golden/bright yellow nodules and microscopically visible foamy histiocytes. Although it is a common lesion of gallbladder, xanthogranuloma of stomach is a highly unique entity with only a few cases documented till date.
Our Case of Xanthogranuloma coexisting with Early Gastric Cancer
A female, aged 65, referred on the account of an epigastralgia, was examined at Naga Municipal Hospital. Upon physical examination, doctors found a well-defined palpable mass in the region of her left hypochondrium. However, she did not show any signs of anemia or jaundice.
Her blood analysis showed a white blood count of 12.25 ×10^3/ microliter. Furthermore, an estimate of her serum levels for tumor markers such as carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) showed them within normal range.
Endoscopy
Next, the doctors performed a gastrointestinal endoscopy. It revealed an ulcerated lesion on the stomach’s lesser curvature, approximately 7cm from the gastro-esophageal junction. Additionally, it showed something similar to an advanced gastric tumor on the anal side of the ulcerated lesion.
Biopsy from the ulcerated lesion indicated an adenocarcinoma and CT scan showed that it was infiltrating the abdominal wall.
A surgery?
Doctors performed an open surgery to completely remove the stomach i.e., gastrectomy, along with resecting some regional lymph nodes too. Histopathology of the specimens showed both a gastric cancer (type 2a and 2c) and xanthogranuloma consisting of lipid laden histiocytes and inflammatory cells. The good thing, xanthogranuloma didn’t have any contact with the gastric cancer.
Anyhow, upon a complete gastrectomy, the patient recovered completely. Discharged on her 16th post-operative day, the patient has not shown any symptoms ever since.
