Clinical Report: Concurrent Intramucosal Gastric Cancer Linked to EBV

Background

Epstein–Barr virus-associated gastric cancer (EBVaGC) is a rare subtype of gastric cancer, accounting for approximately 8.7% of cases globally. It is characterized by specific molecular features, including extensive CpG island methylation and high PD-L1/PD-L2 expression. Understanding the interaction between EBV and Helicobacter pylori is crucial for improving diagnostic and therapeutic strategies in gastric cancer management.

Data Highlights

No numerical data available in the source material.

Key Findings

• EBVaGC accounts for approximately 8.7% of gastric cancers worldwide.
• The case involved a 56-year-old male with two independent foci of intramucosal EBVaGC.
• Active Helicobacter pylori infection was present prior to treatment.
• Endoscopic submucosal dissection (ESD) achieved curative resection without lymphovascular invasion.
• Postoperative pathology confirmed the diagnosis with positive EBER in situ hybridization.
• No recurrence was observed at the 6-month follow-up.

Clinical Implications

The findings suggest that short-term Helicobacter pylori eradication may enhance the detection of minute lesions in the context of EBVaGC. Clinicians should consider the potential benefits of HP treatment prior to endoscopic procedures in similar cases.

Conclusion

This case highlights the importance of recognizing EBVaGC. Further validation in larger cohorts is necessary to confirm these findings.

Related Resources & Content

1. NCCN Clinical Practice Guidelines In Oncology, 2025 -- Gastric Cancer
2. Japanese gastric cancer treatment guidelines 2025 (7th edition)
3. Pan-Asian adapted ESMO Clinical Practice Guidelines for gastric cancer
4. Epstein-Barr Virus–Associated Gastric Cancer: A Histopathologic Study
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6. Frontiers in Immunology — Case Report: A diagnostic chameleon of EBV-associated immune dysregulation: HLH unmasking multiple myeloma with subsequent emergence of aggressive B-cell lymphoma
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9. Timing of H. pylori diagnosis may limit gastric cancer prevention
10. Gastric Cancer, Version 2.2025, NCCN Clinical Practice Guidelines In Oncology - PubMed
11. Japanese gastric cancer treatment guidelines 2025 (7th edition) - PMC
12. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with gastric cancer - ScienceDirect
13. Epstein-Barr Virus–Associated Gastric Cancer: A Histopathologic Study With Comprehensive Molecular Profiling - ScienceDirect
14. Frontiers | Demographic/clinicopathological characteristics and prognosis of resectable Epstein-Barr virus-associated gastric cancer: a nested case-control study from an Eastern China
15. Analysis of clinicopathological and molecular characteristics of EBV-associated gastric cancer | Discover Oncology | Springer Nature Link
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17. Association between Helicobacter pylori and Epstein-Barr virus co-infection and gastric cancer risk: a systematic review and meta-analysis - PubMed
18. Endoscopic risk factors to inform early detection of gastric cancer after Helicobacter pylori eradication: Meta‐analysis and systematic review - PMC
19. Frontiers | Helicobacterpylori eradication following endoscopic resection might prevent metachronous gastric cancer: a systematic review and meta-analysis of studies from Japan and Korea