A Rare Case of Pediatric Gastric Xanthoma: Diagnosis and Follow-up

Abstract

Introduction and Aim: Gastric xanthomas are rare benign lesions that appear to be associated with inflammation of the gastric mucosa. Their etiology has yet to be fully elucidated and only one pediatric case and a few adult cases have been described to date. We report on a pediatric case of gastric xanthomatosis. Case report: A 13-yearold girl with dysphagia, burning sensation in the chest, regurgitation and rumination after meals (with no abdominal pain or altered stool frequency) underwent upper GI endoscopy, disclosing six gastric lesions appearing as nodules and soft pseudo-polyps measuring 0.5-1 cm, with a “papilloma-like” greyish-white top. Histology identified foamy histiocytes leading to the diagnosis of gastric xanthoma. No treatments have been administered to the patient during a 1-year follow-up, and the girl’s signs and symptoms have resolved spontaneously. Discussion and Conclusions: It is important to recognize gastric xanthomas because they often have an ulcerlike appearance at endoscopy, and inappropriate antacid treatment might consequently be prescribed. Taking biopsies during upper GI endoscopy is fundamental to the diagnosis of gastric xanthoma, as well as to exclude gastric tumors.