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DOI: 10.1055/s-0029-1214923
© Georg Thieme Verlag KG Stuttgart · New York
Anisakiasis and vanishing tumor of the cecum
N. Ishii
Department of Gastroenterology
St. Luke’s
International Hospital
9-1 Akashi-cho
Chuo-ku
Tokyo
Japan
104-8560
Fax: +81-3-35440649
Email: naoishi@luke.or.jp
Publication History
Publication Date:
15 September 2009 (online)
There have been few reports to date of vanishing gastric tumors caused by anisakiasis [1]. The large intestine is rarely affected because the ingested larvae usually do not travel that far down the gastrointestinal tract. Colonic anisakiasis occasionally resembles a colonic tumor, because it leads to edema, acute phlegmonous inflammation, or the formation of granulomas around the larvae in the submucosa of the intestinal wall [2].
A 77-year-old man attended our hospital for a positive fecal occult blood test. He was asymptomatic. He had a history of appendectomy for acute appendicitis at the age of 19 and ate raw fish almost every day. His white blood cell count was normal with no eosinophilia. At colonoscopy, a clearly demarcated, depressed lesion with raised margins (similar to a Borrmann type 2 lesion) was identified in the cecum ([Fig. 1]).
The histopathological examination of the biopsy specimens revealed eosinophilic infiltration of the lamina propria mucosae and the submucosa, and necrosis of the epithelium ([Fig. 2]).
Malignant cells were not seen. Computed tomography showed wall thickening in the cecum ([Fig. 3]).
On repeat colonoscopy after 16 days, the tumour resembling a Borrmann type 2 lesion had disappeared and a reddish scar with small erosion was seen in the cecum ([Fig. 4]).
Serum titers of both IgG and IgA antibodies to Anisakis larvae on the day of the second colonoscopy were slightly elevated at 1.61 (cut-off index, normal < 1.50). At another colonoscopy a year later, the tumor had completely disappeared and a whitish scar was seen in the cecum ([Fig. 5]).
The vanishing tumor may be considered to be anisakiasis of the cecum.
Endoscopy_UCTN_Code_CCL_1AD_2AZ
#References
- 1 Takeuchi K, Hanai H, Iida T. et al . A bleeding gastric ulcer on a vanishing tumor caused by anisakiasis. Gastrointest Endosc. 2000; 52 549-551
- 2 Verhamme M A, Ramboer C H. Anisakasis caused by herring in vinegar: a little known medical problem. Gut. 1988; 29 843-847
N. Ishii
Department of Gastroenterology
St. Luke’s
International Hospital
9-1 Akashi-cho
Chuo-ku
Tokyo
Japan
104-8560
Fax: +81-3-35440649
Email: naoishi@luke.or.jp
References
- 1 Takeuchi K, Hanai H, Iida T. et al . A bleeding gastric ulcer on a vanishing tumor caused by anisakiasis. Gastrointest Endosc. 2000; 52 549-551
- 2 Verhamme M A, Ramboer C H. Anisakasis caused by herring in vinegar: a little known medical problem. Gut. 1988; 29 843-847
N. Ishii
Department of Gastroenterology
St. Luke’s
International Hospital
9-1 Akashi-cho
Chuo-ku
Tokyo
Japan
104-8560
Fax: +81-3-35440649
Email: naoishi@luke.or.jp