Skip to main content
NCBI home page
Fujita Medical Journal logoLink to Fujita Medical Journal
. 2022 Oct 28;9(2):163–169. doi: 10.20407/fmj.2022-010

A case of chronic gastric anisakiasis coexisting with early gastric cancer

Eiko Sakurai 1, Masaaki Okubo 2, Yutaka Tsutsumi 3, Tomoyuki Shibata 2, Tomomitsu Tahara 2, Yuka Kiriyama 1, Ayano Michiba 1, Naoki Ohmiya 2, Tetsuya Tsukamoto 1
PMCID: PMC10206891  PMID: 37234391

Abstract

Background:

Anisakiasis is a parasitic disease caused by the consumption of raw or undercooked fish that is infected with Anisakis third-stage larvae. In countries, such as Japan, Italy, and Spain, where people have a custom of eating raw or marinated fish, anisakiasis is a common infection. Although anisakiasis has been reported in the gastrointestinal tract in several countries, reports of anisakiasis accompanied by cancer are rare.

Case presentation:

We present the rare case of a 40-year-old male patient with anisakiasis coexisting with mucosal gastric cancer. Submucosal gastric cancer was suspected on gastric endoscopy and endoscopic ultrasonography. After laparoscopic distal gastrectomy, granulomatous inflammation with Anisakis larvae in the submucosa was pathologically revealed beneath mucosal tubular adenocarcinoma. Histological and immunohistochemical investigation showed cancer cells as intestinal absorptive-type cells that did not produce mucin.

Conclusion:

Anisakis larvae could have invaded the cancer cells selectively because of the lack of mucin in the cancerous epithelium. Anisakiasis coexisting with cancer is considered reasonable rather than coincidental. In cancer with anisakiasis, preoperative diagnosis may be difficult because anisakiasis leads to morphological changes in the cancer.

Keywords: Nematode, Anisakiasis, Stomach, Gastric cancer

Introduction

Health hazards resulting from the ingestion of raw food have distressed people across the world since ancient times. Anisakiasis is a type of food poisoning caused by the ingestion of raw fish infected with larval nematodes of the Anisakidae family. Approximately 20,000 cases of anisakiasis are reported in the world annually, and >90% are from Japan.1 Recently, the consumption of undercooked fish has become popular in other countries; thus, anisakiasis is becoming a global disease. The recent development of transport systems that can deliver fresher fish have increased the prevalence of anisakiasis. In 1960, van Thiel et al.2 first described that this disease was caused by the Anisakis larvae, in the Netherlands.

There are three types of Anisakis larvae: Anisakis simplex (Anisakis larvae type I), Anisakis physeteris (Anisakis larvae type II), and Pseudoterranova decipiens. Among the three types of larvae, Anisakis simplex is the most common pathogen in anisakiasis.

The larvae of Anisakis change their form four times (L1–L3, and the adult worm) in their life cycle. The adult worm lives in marine mammals (final host), such as whales, seals, and dolphins.3 Eggs are produced in the final host and excreted by the mammal into seawater. These first-stage larvae (L1) become embryonated eggs and hatch into free-swimming larvae—the second-stage larvae (L2). Small crustaceans (first intermediate host) eat the L2 larvae, which develop into third-stage larvae (L3). Infected crustaceans are then ingested by fish and squid (second intermediate host). The L3 larvae are transferred from smaller to larger fish, and finally, marine mammals eat infected fish, and the L3 larvae mature into adult worms. If humans consume infected raw or undercooked fish, they can become incidental hosts. The L3 larvae enter the digestive duct and cause anisakiasis. The length of Anisakis third-stage larvae is 20–30 mm.

The following four types of disease are caused by Anisakis larvae: gastric anisakiasis, intestinal anisakiasis, extraintestinal anisakiasis, and Anisakis allergy. Gastric anisakiasis is the most common form, which is caused by direct larval invasion into the gastric mucosa and causes abdominal pain, nausea, and vomiting. The easy availability of endoscopy has enabled the identification of a large number of cases of gastric anisakiasis. Intestinal anisakiasis sometimes leads to extraintestinal anisakiasis if the larvae penetrate the intestinal wall. Anisakis allergy was first reported in 1990 in Japan,4 and there are various symptoms, such as urticaria, digestive symptoms (diarrhea, vomiting, or abdominal pain), and anaphylactic shock. Allergen-specific immunoglobulin E detection is useful for establishing a diagnosis of Anisakis allergy.

The symptoms of anisakiasis are classified as acute and chronic anisakiasis. Patients with acute anisakiasis exhibit serious symptoms, such as severe abdominal pain, nausea, and vomiting. Chronic anisakiasis is asymptomatic or causes mild intermittent abdominal pain for several weeks. If patients have been previously sensitized to Anisakis antigens, acute and drastic symptoms occur as a result of an immediate allergic response. Chronic anisakiasis occurs in never-sensitized patients and presents as a foreign-body reaction in the pathological findings (Table 1).5–7

Table1.

Acute and chronic anisakiasis characteristics

Acute Chronic
Symptoms Severe (abdominal pain, nausea, vomiting) Asymptomatic or mild (intermittent abdominal pain)
Allergic reaction Immediate allergy Not sensitized
Endoscopic findings Anisakis larvae are found on the mucosa, with edema and reddish erosions Submucosal tumor (Anisakis larvae are found in the submucosa)
Pathological findings Eosinophilic phlegmonous inflammation Foreign body granuloma
Open in a new tab

Gastric cancer is the fifth most common and fourth most lethal cancer globally.8 The cause of gastric cancer, the most common histopathological type being adenocarcinoma, is multifactorial, although infection with Helicobacter pylori is a major risk factor for gastric cancer.9 Early gastric cancer is treated with endoscopic resection, whereas the main treatment for non-early operable gastric cancer is surgery.

Although gastric anisakiasis and gastric cancer are common diseases, cases with both diseases coexisting have been reported rarely. It is uncertain whether gastric cancer may provide a beneficial environment for the Anisakis larvae or whether both lesions exist coincidentally.

Here, we describe the case of a patient with anisakiasis coexisting with early gastric cancer.

Case Presentation

A 40-year-old man with a gastric ulcer, which was diagnosed owing to a suspicion of gastric cancer during screening, was referred to our hospital for further diagnostic evaluation.

The patient had a history of a stomach ulcer and reflux esophagitis. Helicobacter pylori eradication was performed 1 year before cancer screening. He expressed no complaints during the medical examination in our hospital.

Gastrointestinal endoscopy (Figure 1) revealed a superficial ulcer on the posterior wall of the corpus of the stomach. Irregular microvascular and microsurface patterns and a demarcation line on a superficial depression were seen using magnifying endoscopy with narrow-band imaging. The lesion was diagnosed as early gastric cancer, and invasion to the submucosa was suspected on endoscopic ultrasonography.

Figure 1.

Figure 1

Open in a new tab

Gastric endoscopy and endoscopic ultrasonography findings. (A) Endoscopy revealed superficial adenocarcinoma (arrow) on the posterior wall in the corpus of the stomach. (B) In the endoscopic ultrasonography, the tumor was suspected to have invaded the second layer (mucosa) with partial invasion into the third layer (submucosa) (arrow).

Contrast-enhanced computed tomography could not clearly identify the lesion in the stomach or metastatic lesions.

The results of a complete blood count and tumor marker evaluation were almost normal, including the eosinophil count (Table 2).

Table2.

Blood chemistry results

Test item Measured value Test item Measured value
WBC 7.4×103/μL LD (LDH) 158 U/L
RBC 4.99×103/μL AMY 116 U/L
PLT 18.4×104/μL BUN 12.1 mg/dL
Basophil 1% Cre 0.95 mg/dL
Eosinophil 1% Na 143 mmol/L
Segmental neutrophil 60% K 3.7 mmol/L
Lymphocyte 35% Cl 107 mmol/L
Monocyte 4% CRP >0.3 mg/dL
AST 17 U/L CEA 1.4 ng/mL
ALT 13 U/L CA19-9 3.8 U/mL
Open in a new tab

WBC, white blood cell; RBC, red blood cell; PLT, platelet; AST, aspartate aminotransferase; ALT, alanine aminotransferase; LDH, lactate dehydrogenase; AMY, amylase; BUN, blood urea nitrogen; Cre, creatinine; Na, sodium; K, postassium; Cl, chloride; CRP, C-reactive protein; CEA, carcinoembryonic antigen; CA19-9, carbohydrate antigen 19-9.

The tentative diagnosis was early gastric cancer with invasion into the submucosa. No metastasis to lymph nodes or other organs was suspected in the clinical findings. Laparoscopic distal gastrectomy was then performed.

A shallow depression was seen on the gastric mucosa in the macroscopic view (Figure 2). Histologically, gastric cancer (well-differentiated tubular adenocarcinoma) was confirmed in the mucosa, without submucosal invasion (Figures 2 and 3A). The fact that the cancerous epithelium was positive for caudal type homeobox 2 (Figure 3B) and cluster of differentiation 10 (Figure 3C) proved that the epithelium was intestinal absorptive epithelium. Mucin core protein (MUC) in the cancer cells was negative for MUC5AC (Figure 3D), MUC6 (Figure 3E), and MUC2 (Figure 3F). Periodic acid-Schiff (PAS) (Figure 3G) and Alcian blue (Figure 3H) staining were also negative, showing that the cancer cells lacked mucin. Ki-67 was irregularly distributed (Figure 3I). Beneath the cancer, granulomas were present in the submucosal lesion (Figure 4A). Necrosis, severe neutrophil and macrophage infiltration, and giant cells were observed in the granulomas (Figure 4B). There were few eosinophils in these areas. Foreign material surrounded by the granulomas was suspected to indicate the Anisakis larval digestive tract (Figure 4C). Immunohistologically, these lesions proved to be chronic gastric Anisakis granulomas (Figure 4D).10

Figure 2.

Figure 2

Open in a new tab

Macroscopic and loupe view. (A and B) Macroscopic view. The yellow square in A is enlarged in panel B. A shallow depression is visible. (C and D) A submucosal granuloma (blue line) beneath the intramucosal adenocarcinoma (red line) is seen in the loupe view.

Figure 3.

Figure 3

Open in a new tab

Histological and immunohistochemical features of the adenocarcinoma in the mucosa. (A) Hematoxylin and eosin staining. (B–F) Immunohistochemistry for cancer phenotype. Intestinal absorptive markers, CD10 (B) and CDX-2 (C). Mucin core proteins (MUCs), MUC5AC (D), MUC6 (E), and MUC2 (F). (G and H) Mucin histochemistry. Cancer cells were negative for mucin with PAS (G) and Alcian blue (H) staining. Proliferative marker, Ki-67 (I). Original magnification, ×200 (A–I).

CD10, cluster of differentiation 10; CDX-2, caudal type homeobox 2; PAS, periodic acid-Schiff.

Figure 4.

Figure 4

Open in a new tab

Granuloma. The submucosal lesion in (A) was a granuloma accompanied by necrosis, severe neutrophil and macrophage infiltration, and the presence of giant cells (B). Foreign material is surrounded by a granuloma in (C) and was proven to be Anisakis larvae immunohistochemically (D). Original magnification, ×12.5 (A) and ×200 (B–D).

Considering these findings, the cancerous lesion was confirmed as intramucosal gastric adenocarcinoma, which coexisted with submucosal granulomas caused by chronic anisakiasis.

Discussion

In this case, we recognized two important issues about cancer coexisting with anisakiasis. First, Anisakis larvae might invade cancerous epithelium selectively. Our immunohistochemical investigation suggested that changes in mucin production in cancer cells could allow the Anisakis larvae to easily invade the gastric epithelium. Second, cancer accompanied by anisakiasis is troublesome for gastroenterologists because in this situation, it might be difficult to make a correct clinical diagnosis before operation. Anisakiasis leads to morphological changes in cancer tissue and an unclear depth of invasion, resulting in an incorrect clinical diagnosis of the cancer depth.

Although there have been reports of cancer with anisakiasis from several countries, most cases have been from Japan. Sonoda et al.11 discussed the details of 29 patients with anisakiasis associated with gastrointestinal cancer in Japan over a 43-year period (1970–2013). In our literature search, we identified 42 cases of cancer coexisting with anisakiasis reported from 1966 to 2021, including our case (Table 3);5,6,11–48 38 cases were reported from Japan. Of the 42 cases, there were 36 reports of gastric cancer with anisakiasis, with 1 report of anisakiasis with duodenal cancer and 5 reports of anisakiasis with colon cancer. Twenty-five cases comprised cancers attached directly to the anisakiasis lesions, whereas other 17 cancers existed separately from the anisakiasis lesions. Among 17 cases, 7 gastric cancers with gastric anisakiasis lesions were located away from each other. In one case,37 colonic anisakiasis was revealed by colonoscopy prior to operation for gastric cancer. Yoo et al.39 overdiagnosed coexisting lesions of colon cancer and colonic anisakiasis as double primary cancer preoperatively. In seven cases,23–25,30–32,41 lymph nodes affected by Anisakis were observed postoperatively, and in four cases,24,30,31,41 enlarged lymph nodes around the cancer were overdiagnosed as metastasis. Three cases (24, 27, and 31) of anisakiasis were overdiagnosed as dissemination of gastric cancer, and three cases (13, 16, 19) of cancer attached directly to the anisakiasis lesions were underdiagnosed as a submucosal tumor or as an ulcer.

Table3.

Previous reports of cases of coexistent cancer and anisakiasis

Year Age Sex Organ of cancer Organ of anisakiasis Attached/ Detached Clinical diagnosis (gross findings/clinical diagnosis of cancer depth) Pathological diagnosis of cancer depth Comparison of clinical and pathological diagnosis Cancer histology pStage Method of resection Author Reference
1966 42 M stomach stomach detached early III+IIc m sig IA subtotal gastrectomy Hara 48
1970 68 M stomach stomach attached early IIa sm tub2 IA subtotal gastrectomy Hayakawa 12
1971 41 M stomach stomach attached benign ulcer ss underdiagnosis tub IIA subtotal gastrectomy Shinohara 13
1973 53 M stomach stomach attached early IIa m tub IA subtotal gastrectomy Nakajima 14
1973 41 M stomach stomach detached — — — — — Ogata 15
1980 72 M stomach stomach attached submucosal tumor sm underdiagnosis tub1 IA subtotal gastrectomy Shinohara 16
1983 73 M stomach stomach attached early IIc m tub1 IA subtotal gastrectomy Tsutsumi 6
1987 48 M stomach stomach attached advanced type III se sig IIIB subtotal gastrectomy Shinoda 17
1988 34 M stomach stomach attached early IIc m sig IA total gastrectomy Hata 18
1988 45 M duodenum duodenum attached duodenal ulcer with perforation ss underdiagnosis sig IIA subtotal gastrectomy Hirata 19
1988 — — stomach stomach detached — — — — gastrectomy Yazaki 20
1991 — — stomach stomach attached early IIc — — — — Kitamura 21
1991 64 F stomach stomach detached early IIc+ submucosal tumor sm sig>por, tub1-tub2 IA gastrectomy Masuda 22
1991 65 M stomach lymph node detached — — — — total gastrectomy Yazaki 23
1992 46 M stomach lymph node, jejunum detached early IIc and metastasis of lymph node and jejunum — overdiagnosis — — total gastrectomy/partial resection of jejunum Hashiguchi 24
1992 59 M stomach lymph node detached early IIc+IIa m tub1 IA distal gastrectomy Nishikawa 25
1992 41 M stomach stomach attached advanced type I sm overdiagnosis pap>medullary with producing AFP IA total gastrectomy Shirasaki 26
1996 65 M stomach peritoneum detached advanced type I and dissemination of peritoneum ss overdiagnosis pap IIA total gastrectomy Tochika 27
1999 71 M stomach stomach attached early IIc m or sm (early) tub2 IA distal gastrectomy Nishioka 28
2000 53 F stomach stomach attached advanced type II ss tub1 IIB distal gastrectomy Kuramochi 29
2000 43 F stomach stomach attached — m or sm (early) tub1 IA subtotal gastrectomy Maggi 30
2000 34 F ascending colon lymph node detached metastasis of lymph node — overdiagnosis tub2 — right hemicolectomy Maggi 30
2003 61 F stomach lymph node, omentum detached early IIb and metastasis of lymph node and omentum m overdiagnosis sig IA distal gastrectomy Sakurai 31
2004 56 M stomach lymph node detached early IIc m or sm (early) tub1 IA distal gastrectomy Ohishi 32
2004 77 M stomach stomach attached early IIc or advanced type III m or sm (early) overdiagnosis pap IA distal gastrectomy Saitoh 33
2004 58 M stomach stomach attached advanced (ss) ss por IIB distal gastrectomy Shibahara 34
2005 53 M stomach stomach detached early IIc — — — — Kato 35
2005 61 M stomach stomach detached early IIa+IIc m sig IA proximal gastrectomy Meguro 36
2006 69 M ascending colon ascending colon attached advanced ss tub1 — right hemicolectomy Mineta 5
2007 71 M stomach transverse colon detached advanced gastric cancer (mp) and colonic submucosal tumor mp tub1 IB distal gastrectomy Satoh 37
2007 68 M stomach stomach detached — — tub1 — — Sunakawa 38
2008 50 F sigmoid colon ascending colon detached double primary cancer ss overdiagnosis — IIA total colectomy Yoo 39
2009 72 F stomach stomach attached early IIc m tub1 IA endoscopic submucosal dissection Ohira 40
2012 45 F sigmoid colon lymph node detached metastasis to lymph nodes ss overdiagnosis tub2 IV sigmoidectomy Hernandez-Prera 41
2012 70 F ascending colon ascending colon attached early (sm) sm pap>por1 IA ileocolic resection Hiramoto 42
2015 63 M stomach stomach attached early IIc sm sig IA distal gastrectomy Sonoda 11
2018 54 M stomach stomach attached advanced (se) mp overdiagnosis tub1, tub2 IB total gastrectomy Nakagawa 43
2020 70s M stomach stomach attached early IIb m tub2>por2, sig — endoscopic submucosal dissection Soma 44
2020 40s F stomach stomach attached early IIb m sig IA endoscopic submucosal dissection Sugai 45
2021 54 M stomach stomach attached advanced (ss) mp overdiagnosis — IB total resection Nonogaki 46
2021 80s M stomach stomach attached advanced (mp) sm overdiagnosis por1>tub2>tub1 IA distal gastrectomy Sai 47
2022 40 M stomach stomach attached early (sm) m overdiagnosis tub1 IA distal gastrectomy Sakurai our case
Open in a new tab

Abbr: m, mucosa; sm, submucosa; mp, muscularis propria; ss, subserosa; se, serosa exposed; tub1, well differentiated tubular adenocarcinoma; tub2, moderately differentiated tubular adenocarcinoma; pap, papillary adenocarcinoma; por1, poorly differentiated adenocarcinoma, solid type; por2, poorly differentiated adenocarcinoma, non-solid type; sig, signet-ring cell carcinoma.

This table is modified from the article by Sonoda et al. (ref. 11).

Clinical cancer depth was misjudged in six cases26,33,43,46,47 including in our case of gastric cancer attached directly to the anisakiasis lesions. In all six cases, the clinical diagnosis of cancer depth was deeper than that of the pathological diagnosis, resulting in overdiagnosis.

In summary, among the 42 cases, there were 12 cases of overdiagnosis and 3 cases of underdiagnosis. Sato et al.,37 Nakagawa et al.,43 and Sai et al.47 reported difficulty in obtaining a preoperative diagnosis in cases of inflammation or granulomas formed by anisakiasis just below the cancer. In our case, the preoperative clinical diagnosis was that of a submucosal cancerous lesion, and postoperatively, the pathological findings revealed that the lesion was mucosal gastric cancer with submucosal granulomatous inflammation accompanied by anisakiasis.

Various histological types of cancer have been reported in cases of cancer with anisakiasis. Twenty-three previous cases were diagnosed as differentiated carcinoma; tubular adenocarcinoma was diagnosed in 19 cases, and papillary carcinoma was diagnosed in 4 cases. Signet cell carcinoma and poorly differentiated adenocarcinoma were diagnosed in nine and two cases, respectively. In most cases, pathological stage I was diagnosed.

In cases of anisakiasis without cancer, it is also important to recognize that anisakiasis might lead to an incorrect clinical diagnosis. Murata et al.49 reported a patient with anisakiasis in the liver that mimicked metastatic liver cancer. The authors stated that inflammatory granulomas in chronic anisakiasis might be confused with other granulomatous diseases, such as gastrointestinal tuberculosis, sarcoidosis, and Crohn’s disease.5 A submucosal lesion associated with an Anisakis larva could be misdiagnosed as a submucosal tumor.50 Submucosal granulomas also misled us regarding the preoperative depth of invasion in our case.16 Yanagishita51 experienced a case of gastric anisakiasis that implied the possibility of latent linitis plastica type gastric cancer because the cancer induced limited swelling of the gastric fold.

Although some reports have shown that the coexistence of Anisakis larvae and cancer is not coincidental,6,11,13,16,18,33 only two reports have discussed a relationship between the change in mucin production in cancer cells and the tendency for Anisakis larvae to invade the cancer. Tsutsumi and Fujimoto6 showed a decrease in mucin production in cancerous epithelium using Alcian blue and PAS staining and stated that the change in mucin production allowed the Anisakis larvae to easily invade the gastric mucosa. In our case, in addition to Alcian blue and PAS staining, immunohistochemical investigation was performed. Our findings also suggest that Anisakis larvae may easily invade abnormal gastric mucosa that produces less mucin than that of normal gastric mucosa.

There are several reports in which Anisakis larvae were present near gastric ulcers. Ino et al.52 showed that Anisakis larvae gathered around an artificial gastric ulcer and implied that the ulcer and cancerous lesions helped the Anisakis larvae penetrate the mucosa. Kasuga et al.53 reported a case of anisakiasis in which Anisakis larvae invaded a gastric ulcer after endoscopic submucosal dissection for early gastric cancer. These cases support our suggestion because ulcerous epithelium is expected to have less mucin than that in normal gastric mucosa.

Acknowledgments

This study was supported by a grant-in-aid for Scientific Research from Fujita Health University to author T. Tsukamoto.

Ethical Approval and Consent to Participate

The ethical approval and documentation for a case report was waived with approval of the Institutional Review Board at Fujita Health University.

Conflict of Interest

The authors declare that they have no conflict of interests.

Consent from the Patient

Written informed consent was obtained from the patient for the publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

References

  • 1.Pravettoni V, Primavesi L, Piantanida M. Anisakis simplex: current knowledge. Eur Ann Allergy Clin Immunol 2012; 44: 150–156. [PubMed] [Google Scholar]
  • 2.van TP, Kuipers FC, Roskam RT. A nematode parasitic to herring, causing acute abdominal syndromes in man. Trop Geogr Med 1960; 12: 97–113. [PubMed] [Google Scholar]
  • 3.Ishikura H. Introduction. In: Gastric Anisakiasis in Japan. Tokyo: Springer-Verlag; 1989: 1–2. [Google Scholar]
  • 4.Kasuya S, Hamano H, Izumi S. Mackerel-induced urticaria and Anisakis. Lancet 1990; 335: 665. [DOI] [PubMed] [Google Scholar]
  • 5.Mineta S, Shimanuki K, Sugiura A, Tsuchiya Y, Kaneko M, Sugiyama Y, Akimaru K, Tajiri T. Chronic anisakiasis of the ascending colon associated with carcinoma. J Nippon Med Sch 2006; 73: 169–174. [DOI] [PubMed] [Google Scholar]
  • 6.Tsutsumi Y, Fujimoto Y. Early gastric cancer superimposed on infestation of an Anisakis-like larva: a case report. Tokai J Exp Clin Med 1983; 8: 265–273. [PubMed] [Google Scholar]
  • 7.Tsutsumi Y. Atlas of infectious disease pathology. Tokyo; Bunkodo, 2000: 233–235 (in Japanese). [Google Scholar]
  • 8.Sekiguchi M, Oda I, Matsuda T, Saito Y. Epidemiological Trends and Future Perspectives of Gastric Cancer in Eastern Asia. Digestion 2022; 103: 22–28. [DOI] [PubMed] [Google Scholar]
  • 9.Tsukamoto T, Nakagawa M, Kiriyama Y, Toyoda T, Cao X. Prevention of Gastric Cancer: Eradication of Helicobacter Pylori and Beyond. Int J Mol Sci 2017; 18: 1699. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Takahashi S, Ishikura H, Hayasaka H. Monoclonal Antibody, Intradermal Reaction, and Sarles’ Phenomenon. In: Gastric Anisakiasis in Japan. Tokyo: Springer-Verlag; 1989: 103–111. [Google Scholar]
  • 11.Sonoda H, Yamamoto K, Ozeki K, Inoye H, Toda S, Maehara Y. An anisakis larva attached to early gastric cancer: report of a case. Surg Today 2015; 45: 1321–1325. [DOI] [PubMed] [Google Scholar]
  • 12.Hayakawa M, Suzuki K, Maeda T, Oikawa K, Ishidate T. Kosankyu nikugesyu ni tomonatta soki igan (IIa) (A case of IIa Type Early Gastric Cancer Associated With Eosinophilic Granuloma). Stomach and Intestine 1970; 5: 223–227 (in Japanese). [Google Scholar]
  • 13.Shinohara S, Ito Y, Hidaka Y, Kurauchi S, Katsura Y. Igan to kyozonseru i anisakissho no ichishorei (A case of stomach cancer and coexistence of gastric anisakiasis). The Japanese Journal of Clinical and Experimental Medicine 1971; 48: 1218–1221 (in Japanese). [Google Scholar]
  • 14.Nakajima H, Hamajima A. Kousankyu nikugeshu wo tomonatta soki igan no 1rei (A Case of Early Gastric Cancer associated with Eosinophlic Granuroma). Akita Journal of Rural Medcine 1973; 20: 136–139 (in Japanese). [Google Scholar]
  • 15.Ogata N, Imai T, Kudo H, Kuge M, Gendo Y, Katsura Y. Ikaiyo gan ni gappeisita i anisakisuyou youchusei kousankyu nikugeshu no 1rei. Journal of Japan Surgical Society 1973; 74: 577 (in Japanese). [Google Scholar]
  • 16.Shinohara A, Yamamoto S, Sakamoto T, Ito J, Nishihara K, Miyata N, Oomari K. IIa-type early gastric cancer presenting as a large submucosal tumor by the underlying submucosal abscess. Stomach and Intestine 1980; 15: 1031–1036 (in Japanese). [Google Scholar]
  • 17.Shinoda M, Takeshita K, Yamagishi S, Miki T, Hasegawa Y, Suzuki T. I anisakisusho niyori hakkenn sareta igan no 1rei. Gatroenterological Endoscopy 1987; 29: 383 (in Japanese). [Google Scholar]
  • 18.Hata Y, Matskawa M, Nomura M, Yamashita K, Irie H. 2cgata soki igan no chokka ni anisakisuyou kosankyusei nikugashu o mitometa 1rei (A case of early gastric cancer associated with eosinophilic granuloma). Internal Medicine 1988; 62: 755–758 (in Japanese). [Google Scholar]
  • 19.Hirata N, Kim M, Maeda K, Nishiyama M, Akamatsu H, Kitagawa A, Okano K. Jyunisicho kaiyou senkoubu ni inkansaibou gan to anisakisu chutaiyou kouzo wo omowaseru ibutsu wo mita 1shou rei (A case of perforated duodenal ulcer, in which observed signet ring cell carcinoma and anisakis like larva). The Japanese Journal of Gastroenterological Surgery 1988; 21: 1323–1326 (in Japanese). [Google Scholar]
  • 20.Yazaki H, Namiki M. Kyuseisyoujyo wo teisuru i anisakisusho no rinshoteki oyobi jikkenteki kento. Gatroenterological Endoscopy 1988; 30: 2714 (in Japanese). [Google Scholar]
  • 21.Kitamura A, Nakamura A, Nakata E, Nomura E, Minami N, Kawai T. I anisakisu sho to sono haikei nenmaku no tokucho (Gastric anisakiasis and the properties of its background mucosa). Medical Postgraduates 1991; 29: 143–147 (in Japanese). [Google Scholar]
  • 22.Masuda K, Sakanoue K, Itakura S, Kagawa K, Itagaki T, Ishida H, Mihara O, Ikeda H. Soki igan ni gappei shita i ikeichu sei kosannkyu sei nikugesyu no 1rei (A case of parasitic eosinophilic granuloma of the stomach early gastric cancer. Medical Journal of Matsue Red Cross Hospital 1991; 3: 65–68 (in Japanese). [Google Scholar]
  • 23.Yazaki S, Fukumoto S, Maejima J, Watanabe T, Takebayashi M, Matsui K. Anisakis larva found in the extirpated lymph node of a patient with gastric cancer. Yonago Acta Medica 1991; 34: 193–200. [Google Scholar]
  • 24.Hashiguchi J, Ito M, Sekine I, Yano A, Harada Y. Fukuku nai rinpa setsu ni kiseisi kosankyu zouta wo mitometa anisakisu sho no 1rei. Nagasaki Medical Journal 1992; 67: 258–260 (in Japanese). [Google Scholar]
  • 25.Nishikawa Y, Tokusa R, Nishimori H, Ogawa K, Miyamoto K. Setsujo i shomo nai ni mitomerareta anisakisu nikugeshu no 1rei. Official Journal of the Japanese Association of Pathologists 1992; 10: 212 (in Japanese). [Google Scholar]
  • 26.Shirasaki S, Miura M, Aida T, Fujino S, Sato F, Madoiwa S, Matsunou H, Konishi F. I anisakisusho wo tomonatta AFP sansei soki igan no 1rei. Gatroenterological Endoscopy 1992; 34: 576–579 (in Japanese). [Google Scholar]
  • 27.Tochika N, Kumon M, Araki K. Shinko igan ni heizon shita fukumaku ishosei anisakisusho no 1rei (A case of ectopic anisakiasis complicating by an advanced gastric cancer). Journal of Japanese Society for Clinical Surgery 1996; 57: 213–215 (in Japanese). [Google Scholar]
  • 28.Nishioka N, Kitahara N, Ishikawa T, Yamashita Y, Sawada T, Koyama T, Ohira M, HIrakawa H. Soki igan ni gappeisita anisakisusho no ichirei. Gatroenterological Endoscopy 1999; 41: 741 (in Japanese). [Google Scholar]
  • 29.Kuramochi J, Goseki N. Igan ni meinyu shita anisakisusho no 1rei (A case of gastric anisakiasis embedded to gastric cancer). Journal of Japanese Society for Clinical Surgery 2000; 61: 3236–3238 (in Japanese). [Google Scholar]
  • 30.Maggi P, Caputi-Iambrenghi O, Scardigno A, Scoppetta L, Saracino A, Valente M, Pastore G, Angarano G. Gatrointestinal infection due to Anisakis simplex in southern Italy. Eur J Epidemiol 2000; 16: 75–78. [DOI] [PubMed] [Google Scholar]
  • 31.Sakurai T, Niina I, Fujiwara M, Yamanari E, Shimayama T, Chichiiwa K. Soki igan ni heizon shita fukuku nai isyosei anisakizusho no 1rei (A case of ectopic anisakiasis associated with early gastric cancer). Journal of Japanese Society for Clinical Surgery 2003; 64: 855–859 (in Japanese). [Google Scholar]
  • 32.Ohishi T, Hasuoka H, Kagei N. I gan shujutsu wo kini rinpasetsunai ni anisakisu yochu wo mitometa 1rei (A case of anisakiasis found in the lymph node of patient with gastric cancer). Clinical Parasitology 2004; 15: 57–58 (in Japanese). [Google Scholar]
  • 33.Saitoh K, Hashida H, Iwashiro N, Ohrara M, Ishizawa M, Kondo S, Kato H. A case of IIc type early gastric cancer associated with eosinophilic granuloma produces by gastric anisakiasis. The Japanese Journal of Gastroenterological Surgery 2004; 37: 1829–1833 (in Japanese). [Google Scholar]
  • 34.Shibahara K, Amaya S, Kurokawa M, Yagi S, Uozu K, Hasegawa H, Maeda N. I anisakissho ni yotte sukirusuyouno naisikyo shoken wo teisitato omowareru sinko igan no 1rei. Journal of Japanese Society for Clinical Surgery 2004; 65: 1241–1244 (in Japanese). [Google Scholar]
  • 35.Kato T, Matsui T. Toin de 20nenkan ni hakkensareta soki igan 101rei no rinshoteki kento (Clinical study of 101 patients with early gastric cancer in Minamikayabe). Journal of the Medical Assoc South Hokkaido 2005; 40: 13–14 (in Japanese). [Google Scholar]
  • 36.Meguro E, Inaba T, Irinoda T, Hayakawa Y, Okada S, Kaizuka H. Kyusei anisakisusho wo keikini hakken sareta soki igan no 1rei (A patient with early gastric cancer incidentally detected during treatment for acute anisakiasis). Surgery 2005; 67: 226–229. [Google Scholar]
  • 37.Sato M, Hiraga M, Shiiba K. Igan jutsuzen kensazi ni hakken sareta daicho anisakisusho no 1rei (A case of asymptomatic colonic anisakiasis during colonoscopy for preoperation of gastric cancer). Journal of the Japan Society of Coloproctology 2007; 60: 421–425 (in Japanese). [Google Scholar]
  • 38.Sunagawa K, Fuchinoue F, Hommma T, Kinukawa N, Oinuma T, Hayashi Y, Katsura Y, Nemoto N. Shokakan anisakisusho no rinshoteki oyobi byourigakuteki kento. Japanese Journal of Diagnostic Pathology 2007; 24: 175–177 (in Japanese). [Google Scholar]
  • 39.Yoo HJ, Kim SH, Lee JM, Kim MA, Han JK, Choi BI. The association of anisakiasis in the ascending colon with sigmoid colon cancer: CT colonography findings. Korean J Radiol 2008; 9: S56–S60. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40.Ohira T, Hirasawa D, Noda Y, Suzuki T, Sugawara T, Harada Y, Sato C, Maeda Y, Kanno Y, Ogawa T, Koike Y, Suzuki K, Yamagata T, Fujita N. Byohen no chokka ni anisakisuchutai wo mitometa soki igan no 1rei (A case of early gastric cancer associated with granuloma due to anisakis directly under the tumor). Endoscopia Digestiva 2009; 21: 1757–1762 (in Japanese). [Google Scholar]
  • 41.Hernandez-Prera JC, Polydorides AD. Anisakidosis of the sigmoid colon disguising as metastatic carcinoma: a case report and review of the literature. Pathol Res Pract 2012; 208: 433–435. [DOI] [PubMed] [Google Scholar]
  • 42.Hiramoto K, Kuroki M, Nakano E, Nanno N, Matsumura Y, Miura A, KIkuchi Y, Hirakawa H, Matsuda M. Anisakis no sinyu wo naisikyoteki ni kakuninsieta jyokokecho gan no 1rei (A case of ascending colon cancer in which an anisakis parasite was revealed protruding from the tumor during colonoscopy). Gatroenterological Endoscopy 2012; 54: 1656–1661 (in Japanese). [Google Scholar]
  • 43.Nakagawa T, Sasaki Y, Funahashi O, Tsutsumi K, Sasaki M, Kinoshita T, Kumano R, Satta Y, Suhara H, Yoshida D. I anisakisusho niyori jyutsuzen sintatsudo sindan ga konnandeatta sinko igan no 1rei. Nihon Shokakibyo Gakkai Tokai Shibu Reikai Puroguramu Shorokushu 2018; 129: 63 (in Japanese). [Google Scholar]
  • 44.Soma M, Hagiyama S, Higashihara K, Seto K, Iwasaki T, Kuriyama D, Horiki Y, Sanomura J, Imanaka K, Murayama Y, Tsutsui S, Iiishi H. ESD wo sikousita soki igan no chokka ni anisakisu niyoru kosankyusei nikugeshu wo mitometa 1rei. Nihon Shokaki Naishikyo Gakkai Kinki Shibu Reikai Puroguramu Shorokushu 2020; 105: 67 (in Japanese). [Google Scholar]
  • 45.Sugai Y, Kitagawa T, Ota T, Fujiwara T, Okada S, Masaoka R, Katayama Y, Ban S, Tamano M. Anisakisu ga sinyusita soki igan ni taisite naisikyoteki nenmakukasou hakurijyutu wo sikosita 1rei. Nihon shokakibyo gakkai kanto shibu reikai puroguramu shorokushu 2020; 360: 32 (in Japanese). [Google Scholar]
  • 46.Nonogaki A, Miwa T, Tanaka Y, Mashita N, Ishigure K. Anisakisu kansen wo heihatsu shita igan no 1rei (A case of gastric cancer with anisakis infection). Nihon Igan Gakkai Sokai Kiji 2021; 93: 358 (in Japanese). [Google Scholar]
  • 47.Sai A, Katada K, Yamauchi K, Taketani H, Fukui A, Harusato A, Okayama T, Nakai R, Sumiyoshi S, Harada K, Takemoto K, Koshino K, Toma A, Ochiai T, Itoh Y. Anisakisusho niyoru kosankyusei nikugesyu wo gappeisita soki iganno ichirei (A case of early gastric cancer with eosinophilic granuloma). Journal of North Medical Center, Kyoto Prefectural University of Medicine 2021; 7: 39–43 (in Japanese). [Google Scholar]
  • 48.Hara Y, Sawada Y, Tsunoda H, Hida Y. Soki igan to iseichu ni yoru nikugeshu no kyozonseru 1rei. Stomach and Intestine 1966; 1: 825–827 (in Japanese). [Google Scholar]
  • 49.Murata Y, Ando K, Usui M, Sugiyama H, Hayashi A, Tanemura A, Kato H, Kuriyama N, Kishiwada M, Mizuno S, Sakurai H, Isaji S. A case of hepatic anisakiasis caused by Pseudoterranova decipiens mimicking metastatic liver cancer. BMC Infect Dis 2018; 18: 619. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 50.Harima Y, Kono M, Tanimura T, Sugihara T, Murawaki Y, Miura M, Tanaka S, Yoshimura T, Yamada M. A case of gastric anisakiasia diagnosis as gastric submucosal tumor. The Medical Journal of Matsue City Hospital 2011; 15: 91–96 (in Japanese). [Google Scholar]
  • 51.Yanagishita A, Ono H, Kakushima N, Takizawa K, Tanaka M, Ikehara H, Matsubayashi H, Yamaguchi Y. Eosinophic gastric due to suspected anisakiasis showing limited gastric fold, report a case. Stomach and Intestine 2010; 45: 511–514. [Google Scholar]
  • 52.Ino H, Tomioka T, Akaiwa J. Marena ibyoheni no kiseichusei nikugashu ianisakissho oyobi anisakisyo yochu (About parasitic granuloma, anisakiasia and anisakis-like larva of stmach). Stomach and Intestine 1969; 4: 601–608 (in Japanese). [Google Scholar]
  • 53.Kasuga K, Tanaka H, Hosaka H, Uraoka T. Anisakis with a Gastric Ulcer after Endoscopic Resection. Intern Med 2022 (epub ahead of print). [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Fujita Medical Journal are provided here courtesy of Fujita Medical Society

RESOURCES