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M
énétrier
’
s
disease
associated
with
gastric
adenocarcinoma
in
a
child
–
imaging
aspect
R
ev
A
ssoc
M
ed
B
ras
2016; 62(6):485-489
489
-dependent. The findings are wall thickening, usually
diffuse, or a hypoechoic mass with echogenic center or
“pseudo-kidney” sign.
16
CT is the method of choice because, in addition to
identifying the primary tumor, it assesses the signs of lo-
cal invasion, regional and distant lymph node involvement,
as well as metastases. Imaging findings vary depending on
the type and grade of the tumor, including diffuse or seg-
mental thickening with intravenous contrast enhancement,
masses, ulceration, and loss of distensibility.
16,19
UGE is the method of choice for definitive diagnosis,
because it is more sensitive and allows biopsies to be per-
formed for histopathologic analysis.
16
Endoscopic ultrasonography is currently the best
method for assessing the primary tumor as well as eval-
uating the local extent of the tumor and the presence of
compromised regional lymph nodes.
19
Recent studies have demonstrated the role of MRI in
the diagnosis of early gastric carcinomas that are not seen
on other imaging tests.
20
The rarity of gastric cancer in children makes this di-
agnosis a very remote possibility among pediatricians.
Also, the initial nonspecific gastrointestinal symptoms
eventually lead to a significant delay in diagnosis, result-
ing in late start of appropriate treatment. As a result, gas-
tric adenocarcinomas in pediatric patients have more ad-
vanced stage at diagnosis, presenting worse prognosis
compared to adults.
13,14
Treatment of GAC in children is usually based on
methods used in adults, due to the rarity of this disease
in pediatric populations, and therefore there is no stan-
dard treatment model.
13,15
R
eferences
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