To report a case of synchronous intramucosal Epstein–Barr virus-associated gastric cancer (EBVaGC).
Approach:
Case Presentation: A 56-year-old male patient diagnosed with gastric adenocarcinoma underwent HP eradication followed by endoscopic submucosal dissection (ESD).
Diagnostic Techniques: Magnifying endoscopy with narrow-band imaging (ME-NBI) was utilized to assess lesions obscured by HP-induced inflammation.
Treatment Protocol: The patient received a 2-week HP eradication regimen prior to ESD.
Key Findings:
Two distinct superficial depressed lesions were identified and removed en bloc.
Postoperative pathology confirmed two independent foci of intramucosal EBVaGC with positive EBER in situ hybridization.
The lesions were limited to the mucosa without lymphovascular invasion.
Interpretation:
Short-term preoperative HP eradication may improve detection of minute lesions in cases of EBVaGC.
Limitations:
Findings are based on a single case report and require validation in larger cohorts.
No current clinical guidelines recommend routine pre-ESD HP eradication.
Conclusion:
This case highlights the role of HP eradication in the context of EBVaGC.
