Korean J Parasitol.  2015 Feb;53(1):95-99. 10.3347/kjp.2015.53.1.95.

Comorbid Gastric Adenocarcinoma and Gastric and Duodenal Strongyloides stercoralis Infection: A Case Report

• Seo AN
• Goo YK
• Chung DI
• Hong Y
• Kwon O
• Bae HI

• KMID: 2381801
• DOI: http://doi.org/10.3347/kjp.2015.53.1.95

Abstract

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.

Keyword

Strongyloides stercoralis; gastric adenocarcinoma; PCR; formalin-fixed paraffin-embedded tissue

MeSH Terms

Adenocarcinoma/*complications/*diagnosis/pathology
Aged, 80 and over
Albendazole/therapeutic use
Animals
Anthelmintics/therapeutic use
DNA, Helminth/chemistry/genetics
DNA, Ribosomal/chemistry/genetics
Endoscopy, Digestive System
Female
Histocytochemistry
Humans
Korea
Male
RNA, Ribosomal, 18S/genetics
Sequence Analysis, DNA
Stomach Neoplasms/*complications/*diagnosis/pathology
Strongyloides stercoralis/*isolation & purification
Strongyloidiasis/*complications/*diagnosis/drug therapy/pathology
Treatment Outcome
Albendazole
Anthelmintics
DNA, Helminth
DNA, Ribosomal
RNA, Ribosomal, 18S