Cytomegalovirus-related Gastritis in a Patient with Solid and Papillary Epithelial Neoplasm of Pancreas

復發性胰臟實質乳突狀腫瘤合併巨細胞病毒胃炎

陳佳宏(Jia-Hong Chen) ； 張維國(Wei-Kuo Chang) ； 何景良(Ching-Liang Ho) ； 陳宇欽(Yeu-Chin Chen) ； 張平穎(Ping-Ying Chang)

《台灣癌症醫學雜誌》 29卷4期 (2013/10) Pp. 201-205

https://doi.org/10.6323/JoCRP.2013.29.4.5

摘要

胰臟實質乳突狀腫瘤是一種主要發生於年輕女性，罕見的低度惡性腫瘤，甚少發生遠端轉移及復發。我們報告一位診斷為胰臟實質乳突狀腫瘤的四十五歲女性，在手術後兩年發生多處轉移，經過多線化學治療與放射治療後因多日解黑便而住院，胃鏡發現多處胃潰瘍，高度懷疑胃轉移。切片證實為巨細胞病毒胃炎。

關鍵字

巨細胞病毒胃炎 ； 胰臟實質乳突狀腫瘤

並列摘要

Background: The solid and papillary epithelial neoplasm of the pancreas (SPENP) is a low grade malignancy and has a predilection for young woman patients. Local recurrence or distant metastasis has been very rarely reported. Death caused by the tumor metastases has rarely occurred. Here, we report a patient with recurrent SPENP, who developed cytomegalovirus (CMV)-related gastric ulcer mimicking carcinoma after chemotherapy and radiotherapy.Case Report: A 45-year-old woman with a 2 years' history of SPENP developed multiple liver metastases one year after surgery and underwent palliative chemotherapy and radiotherapy. She was admitted because of intermittent fever and melena episodes for several days. An upper GI endoscopy revealed multiple ulcerative lesions in the antrum of the stomach which were thought to be metastatic carcinoma. The pathological report, however, revealed CMV inclusion bodies in the gastric mucosa and there was no evidence of malignancy. Blood CMV PCR assay also showed CMV-positive results. The symptoms of fever and melena improved after two weeks of ganciclovir treatment.Conclusions: CMV disease should be considered in cancer patients with unusual GI symptoms. Early intervention with antiviral therapy can improve outcome and reduces severe complications.

並列關鍵字

CMV gastritis ； solid and papillary epithelial neoplasm of pancreas