Advanced gastric carcinoma in an 18-year-old man: A case report

We report a case of advanced gastric adenocarcinoma (stage IVb) in an 18-year-old Japanese man who underwent extensive surgery followed by intensive adjuvant chemotherapy. We also review 12 cases of gastric carcinoma in teenagers, including this case. We found that gastric carcinoma in teenagers had the following characteristics similar to those found in older patients with the disease: 1) there was no sexual predominance (male:female = 5:7) and no familial tendency; 2) epigastric pain was the most common symptom (58.3%, 7/12); 3) depressed tumors on macroscopic examination and undifferentiated adenocarcinoma on histologic examination were common (83.3%, [10/12] and 75%, [9/12], respectively); and 4) total gastrectomy was performed in more than half of the patients (7/12). In some cases, chemotherapy was effective for advanced disease, although there was no response in this case. Teenagers with persistent upper abdominal symptoms should undergo endoscopy for histologic diagnosis, because early diagnosis may be lifesaving.