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(102). Gastric cancer: Retrospective analysis of the radiologic aspects
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Helicobacter pylori and cancer / Arab Journal of Gastroenterology 10 (2009) AB45–AB52
upper gastrointestinal hemorrhage (7 cases), dysphagia (6 cases), epigastric mass (3 cases), anemic syndrome (2 cases). Gastroscopy was done in 4 asymptomatic patients, for control of an operated tumor of the cardia in 1 case and research for the primary tumor in 3 cases. Results: Endoscopic aspect was ulcerative budding (30 cases), budding (2 cases), large ulcerated folds (3 cases), gastric ulcer (2 cases) and a bud in oesojejunal anastomosis (1 case). Gastric tumor was localized in 35 cases (fundus: 16 cases, antrum: 11 cases, a small curvature: 3 cases, subcardial area: 4 cases, oesojejunal anastomosis: 1 case) and diffuse in 3 cases. Histological type was specified in 13 patients: diffuse in 12 cases, intestinal in 1 case. ADK was poorly differentiated in 4 cases, moderately differentiated in 16 cases and differentiated in 5 cases. Hp statue was studied in 13 patients (34%): positive in 8 (61%) cases and negative in 5 cases. Gastric atrophy with intestinal metaplasia was present in 4 cases and with severe dysplasia in one case. Conclusion: In our study, the most frequent endoscopic aspect was ulcerative budding, diffuse type and moderately differentiated. The discovery of Hp as a carcinogen factor is the main improvement during the last ten years. Systematic research of Hp should decrease the incidence of this cancer. doi:10.1016/j.ajg.2009.07.124
(101) Gastric cancers: Comparative study in a Moroccan population M. Belhassan, N. Benzzoubeir, H. Tlemsani, I. Errabih, H. Krami, L. Ouazzani, H. Ouazzani Medical Clinic B, Hepato-gastroenterology and Proctology, CHU Ibn Sina, Rabat, Morocco
Gastric cancer is the second most prevalent cancer in the world and a major cause of death in Morocco. The prognosis is poor when the diagnosis is late. The purpose of the study is to reveal and compare the epidemiological characteristics of gastric cancer in a Moroccan population through the experience of our service. Methods: This is a retrospective study over 8 years, from January 2000 to December 2008, conducted at the Medical Clinic B, CHU Ibn Sina of Rabat. 285 gastric cancer cases were collected during this period. Results and discussions: Gastric cancer is the most frequent cancer in our service. The average age was 58 years. Regarding the localization, 43% of gastric cancers were proximal and 47% were distal. The predominant histological type is the adenocarcinoma. During this study, we noted a variation in the frequency of fundic cancer: it has increased from 6 to 13 cases per year. The common time of diagnosis was late (8.7 months), the principal reason was the atypical clinical presentation. Conclusion: Our study reveals a gradual change and recent epidemiological profile of gastric cancer. The confirmation of these results and the search for common etiological factors require studies at the national level. doi:10.1016/j.ajg.2009.07.125
(102) Gastric cancer: Retrospective analysis of the radiologic aspects H. El Koundi, H. Zian, S. Tahri, L. Jroundi, I. Chami, N. Boujida Department of Radiology, Institut National d’Oncologie, Rabat, Morocco
Background: The cancer of the stomach is the most frequent second cancer in the world, considering approximately 10% of the cases
of cancer. It represents the 2nd cause of mortality by cancer. In more than 90% of the cases, it is an adenocarcinoma. Purpose: This work has a didactic purpose, that to describe radiologic findings of gastric cancer selected from the database of our establishment. Material and methods: Data were collected retrospectively from patients with gastric cancer who presented to the service of radiology of the national institute of oncology. This work illustrates their various features in CT scan and in magnetic resonance imaging (MRI). The histological data are available in every case and correlated to those of radiological imaging features. Results: These cases include primitive gastric tumors (adenocarcinoma, lymphoma and stromal tumors). Radiological imaging provided: – Diagnosis. – TNM classification. – A good follow up before and after curative or palliative treatment. The radiological aspect of adenocarcinoma was a focal or circumferential parietal thickening which is enhanced heterogeneously, with or without infiltration of the perigastric fat. The radiological aspects of the gastric lymphoma are variable. They can appear like a wall thickening (often superior to 20 mm), with ulcerated small or voluminous nodules. The CT features of the gastric stromal tumors show an heterogeneous exogastric development, with cystic and necrotic component, Mucosal ulceration and a predominating peripheral enhancement. The MRI showed the same aspects. Conclusion: Imaging studies, especially CT, play an important role not only in the detection and the localization but also in the evaluation of the extension and follow-up of theses tumors. Using only CT aspects, we can suspect the diagnosis. The MRI seems to be more sensitive than the CT scan in detecting parietal extension. But, it is less successful than the scanner to determine the lymph node invasion. doi:10.1016/j.ajg.2009.07.126
(103) Biermer’s disease and gastric carcinoid tumor H. El Koundi, H.E. Krami, G. kharasse, M. Fadlollah, M. Tamzaourt, I. Errabih, N. Benzoubeir, L. Ouazzani, H. Ouazzani Clinique Médicale ‘B’, CHU Ibn Sina, Rabat, Morocco
Background: Gastric carcinoids are rare neuroendocrine tumors that account for 2% of all gastrointestinal carcinoids and 0.3% of all gastric neoplasms. They may occur sporadically or secondary to chronic hypergastrinemia. Its occurrence during biermer’s anemia was previously reported in the literature. The relative risk is estimated at 26.4 in patients suffering from biermer’s anemia. Purpose: The aim is to rview the presentation, treatment, and outcome of a patient with gastric carcinoid tumor Type 1. Case report: A 46 years old woman, following for Biermer disease under vitamin B12 treatment since 13 years, was admitted to our clinic with complaints of epigastralgy and weakness. Physical examination was normal. There was no laboratory finding of anemia. Serum fasting gastrin level was 1491 pg/ml (N: 25–125). 5 HIAA and chromogranin A levels were normals Gastroscopic examination showed an atrophic gastritis and small lesion with a diameter of 0.5 cm on the fundus. Endoscopic biopsies of the lesion were done. Histopathological examination was compatible with well-differentiated carcinoid tumor, there was no helicobacter pylori. The specimen
Helicobacter pylori and cancer / Arab Journal of Gastroenterology 10 (2009) AB45–AB52
upper gastrointestinal hemorrhage (7 cases), dysphagia (6 cases), epigastric mass (3 cases), anemic syndrome (2 cases). Gastroscopy was done in 4 asymptomatic patients, for control of an operated tumor of the cardia in 1 case and research for the primary tumor in 3 cases. Results: Endoscopic aspect was ulcerative budding (30 cases), budding (2 cases), large ulcerated folds (3 cases), gastric ulcer (2 cases) and a bud in oesojejunal anastomosis (1 case). Gastric tumor was localized in 35 cases (fundus: 16 cases, antrum: 11 cases, a small curvature: 3 cases, subcardial area: 4 cases, oesojejunal anastomosis: 1 case) and diffuse in 3 cases. Histological type was specified in 13 patients: diffuse in 12 cases, intestinal in 1 case. ADK was poorly differentiated in 4 cases, moderately differentiated in 16 cases and differentiated in 5 cases. Hp statue was studied in 13 patients (34%): positive in 8 (61%) cases and negative in 5 cases. Gastric atrophy with intestinal metaplasia was present in 4 cases and with severe dysplasia in one case. Conclusion: In our study, the most frequent endoscopic aspect was ulcerative budding, diffuse type and moderately differentiated. The discovery of Hp as a carcinogen factor is the main improvement during the last ten years. Systematic research of Hp should decrease the incidence of this cancer. doi:10.1016/j.ajg.2009.07.124
(101) Gastric cancers: Comparative study in a Moroccan population M. Belhassan, N. Benzzoubeir, H. Tlemsani, I. Errabih, H. Krami, L. Ouazzani, H. Ouazzani Medical Clinic B, Hepato-gastroenterology and Proctology, CHU Ibn Sina, Rabat, Morocco
Gastric cancer is the second most prevalent cancer in the world and a major cause of death in Morocco. The prognosis is poor when the diagnosis is late. The purpose of the study is to reveal and compare the epidemiological characteristics of gastric cancer in a Moroccan population through the experience of our service. Methods: This is a retrospective study over 8 years, from January 2000 to December 2008, conducted at the Medical Clinic B, CHU Ibn Sina of Rabat. 285 gastric cancer cases were collected during this period. Results and discussions: Gastric cancer is the most frequent cancer in our service. The average age was 58 years. Regarding the localization, 43% of gastric cancers were proximal and 47% were distal. The predominant histological type is the adenocarcinoma. During this study, we noted a variation in the frequency of fundic cancer: it has increased from 6 to 13 cases per year. The common time of diagnosis was late (8.7 months), the principal reason was the atypical clinical presentation. Conclusion: Our study reveals a gradual change and recent epidemiological profile of gastric cancer. The confirmation of these results and the search for common etiological factors require studies at the national level. doi:10.1016/j.ajg.2009.07.125
(102) Gastric cancer: Retrospective analysis of the radiologic aspects H. El Koundi, H. Zian, S. Tahri, L. Jroundi, I. Chami, N. Boujida Department of Radiology, Institut National d’Oncologie, Rabat, Morocco
Background: The cancer of the stomach is the most frequent second cancer in the world, considering approximately 10% of the cases
of cancer. It represents the 2nd cause of mortality by cancer. In more than 90% of the cases, it is an adenocarcinoma. Purpose: This work has a didactic purpose, that to describe radiologic findings of gastric cancer selected from the database of our establishment. Material and methods: Data were collected retrospectively from patients with gastric cancer who presented to the service of radiology of the national institute of oncology. This work illustrates their various features in CT scan and in magnetic resonance imaging (MRI). The histological data are available in every case and correlated to those of radiological imaging features. Results: These cases include primitive gastric tumors (adenocarcinoma, lymphoma and stromal tumors). Radiological imaging provided: – Diagnosis. – TNM classification. – A good follow up before and after curative or palliative treatment. The radiological aspect of adenocarcinoma was a focal or circumferential parietal thickening which is enhanced heterogeneously, with or without infiltration of the perigastric fat. The radiological aspects of the gastric lymphoma are variable. They can appear like a wall thickening (often superior to 20 mm), with ulcerated small or voluminous nodules. The CT features of the gastric stromal tumors show an heterogeneous exogastric development, with cystic and necrotic component, Mucosal ulceration and a predominating peripheral enhancement. The MRI showed the same aspects. Conclusion: Imaging studies, especially CT, play an important role not only in the detection and the localization but also in the evaluation of the extension and follow-up of theses tumors. Using only CT aspects, we can suspect the diagnosis. The MRI seems to be more sensitive than the CT scan in detecting parietal extension. But, it is less successful than the scanner to determine the lymph node invasion. doi:10.1016/j.ajg.2009.07.126
(103) Biermer’s disease and gastric carcinoid tumor H. El Koundi, H.E. Krami, G. kharasse, M. Fadlollah, M. Tamzaourt, I. Errabih, N. Benzoubeir, L. Ouazzani, H. Ouazzani Clinique Médicale ‘B’, CHU Ibn Sina, Rabat, Morocco
Background: Gastric carcinoids are rare neuroendocrine tumors that account for 2% of all gastrointestinal carcinoids and 0.3% of all gastric neoplasms. They may occur sporadically or secondary to chronic hypergastrinemia. Its occurrence during biermer’s anemia was previously reported in the literature. The relative risk is estimated at 26.4 in patients suffering from biermer’s anemia. Purpose: The aim is to rview the presentation, treatment, and outcome of a patient with gastric carcinoid tumor Type 1. Case report: A 46 years old woman, following for Biermer disease under vitamin B12 treatment since 13 years, was admitted to our clinic with complaints of epigastralgy and weakness. Physical examination was normal. There was no laboratory finding of anemia. Serum fasting gastrin level was 1491 pg/ml (N: 25–125). 5 HIAA and chromogranin A levels were normals Gastroscopic examination showed an atrophic gastritis and small lesion with a diameter of 0.5 cm on the fundus. Endoscopic biopsies of the lesion were done. Histopathological examination was compatible with well-differentiated carcinoid tumor, there was no helicobacter pylori. The specimen