A Surgical Case of Multiple Gastric Cancers on the Background of Nodular Gastritis in a Twelve-Year-Old Child

Herein, we report a young surgical case of multiple gastric cancers on the background of nodular gastritis with Helicobacter pylori infection. A 12-year-old girl with a family history of advanced gastric cancer in young age in her paternal grandfather, maternal grandfather, and father, was admitted with anemia. Upper gastrointestinal endoscopy showed a type-3 advanced cancer and five 0-IIc type early cancers in the body of the stomach as well as nodular gastritis in the antrum. Histological examination of the biopsy samples detected poorly differentiated carcinoma and signet ring cell carcinoma in all six lesions. The type-3 gastric cancer was preoperatively diagnosed as cT2N0M0P0, cStage IB. The patient underwent total gastrectomy with Roux-en-Y reconstruction. The histopathological diagnosis of the resected specimen was pT3(SS)pN0M0P0CY0, pStage IIA. E-cadherin staining was positive in the tumor. Nodular gastritis with Helicobacter pylori infection was confirmed histologically. The patient received adjuvant chemotherapy with S-1, and no tumor recurrence was observed during 62 months follow-up after surgery. This is a rare case of multiple diffuse-type gastric cancers in a young patient, not only with the histological background of nodular gastritis with Helicobacter pylori infection, but also with a family history of diffuse-type gastric cancer.