Volume 78 - 2015 - Fasc.3 - Case reports
Eosinophilic ascites secondary to toxocariasis
Eosinophilic ascites is a very rare disorder. It can be a manifesta- tion of the eosinophilic gastroenteritis in its serosal form or it can be secondary to infections, malignancies, vasculitis or hypereosino- philic syndrome. Among all infections, the ones produced by inva- sive helminth parasites should be initially suspected and ruled out. We report the case of a patient with eosinophilic ascites associated with diarrhea, abdominal pain and eosinophilia in peripheral blood. Eosinophilic colitis was also demonstrated in a colonic biopsy and empirical steroid treatment was started for suspected eosinophilic gastroenteritis. Later on, the patient improved ; the ascites disappeared and the eosinophil blood count returned to nor- mal. Subsequently, serologic testing for toxocariasis was received positive and therefore, the diagnosis of eosinophilic gastroenteritis was discarded ; albendazole was also added to treatment. The patient remained asymptomatic on follow-up. We emphasize the need to rule out parasitic infections in all patients with gastrointes- tinal symptoms, eosinophilia and eosinophilic infiltration of gastro- intestinal tissues. (Acta gastroenterol. belg., 2015, 78, 332-335).
Gastric adenocarcinoma of fundic gland type (chief cell predominant type) with unique endoscopic appearance curatively treated by endoscopic submucosal resection
Gastric adenocarcinoma of fundic gland type [chief cell predom- inant type ; (GA-FD-CCP)] is a rare gastric cancer variant arising from non-atrophic mucosa without Helicobacter pylori infection in the upper third portion of the stomach. GA-FD-CCP originates deep in the mucosal layer ; hence, endoscopic lesion detection is often difficult at an early stage because of a minimal change in the mucosal surface. Here we present a 66-year-old man with an early stage of GA-FD-CCP showing characteristic endoscopic features. Esophagogastroduodenoscopy demonstrated a flat, slightly reddish area with black pigment dispersion and irregular micro-surface structure at the gastric fornix. The tumor was resected by endo- scopic submucosal dissection and was pathologically diagnosed as GA-FD-CCP. Prussian blue staining revealed that the black pigment was a hemosiderin deposition. We reported a rare case of successfully treated GA-FD-CCP with black pigmentation that aided in early lesion detection. (Acta gastroenterol. belg., 2015, 78, 336-339).
An unusual neoplasm of the pancreas : Pancreatic metastasis of a Merkel cell carcinoma. Case report and review of the literature
Isolated pancreatic metastases are rare. The differential diagno- sis of pancreatic neoplasms can be difficult, especially it can be troublesome to obtain tissue diagnosis. However, pancreatic lesions in patients with a history of a malignancy must be considered to be metastases.
We present a case of a patient with a history of a Merkel cell carcinoma (MCC) in the neck. Twelve months after this diagnosis a follow-up CT shows a large isolated tumor in the head of the pan- creas. Histological and immunohistochemical studies of specimen obtained through ultrasound-guided transabdominal biopsy, show similar characteristics as the primary MCC.
To our knowledge twelve cases of a pancreatic metastasis of a MCC have been reported in English literature. A review of the literature was performed. (Acta gastroenterol. belg., 2015, 78, 340- 343).
