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A woman with CTLA4 insufficiency had recurrent infections from early childhood and was diagnosed with common variable immunodeficiency as a teenager. At age 20, evaluation for neurologic symptoms revealed vitamin B12 deficiency and pernicious anemia. Gastroscopy then found an early gastric adenoma with high-grade dysplasia, which was removed by endoscopic submucosal dissection.
Regular endoscopic follow-up continued because chronic active gastritis persisted. At age 25, surveillance gastroscopy found poorly differentiated gastric adenocarcinoma. The tumor was not associated with EBV or CMV.
She underwent laparoscopic subtotal gastrectomy. Chemotherapy was not given. Her ongoing immune deficiency continued to be managed with immunoglobulin replacement, but this was separate from the gastric-cancer treatment.
At the latest follow-up she had experienced no gastric-cancer relapse for more than 3 years after surgery. At more than 3 years after surgery, she remained free of gastric-cancer relapse.
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
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