A CASE OF GASTRIC CANDIDIASIS COMPLICATING LEIOMYOMA OF THE STOMACH : SUCCESSFUL TREATMENT BY ENDOSCOPIC INJECTION THERAPY WITH MICONAZOLE

Abstract

A 78-year-old man who developed gastric candidiasis complicating leiomyoma of the stomach is described. A submucosal tumor at the cardia and an ulcer in the antrum were found by endoscopic examination. After treatment with H₂-blocker for the ulcer and broad-spectrum antibiotics for respiratory tract infection, the tumor developed an irregular ulceration on the surface and a yellow-white protrusion with coagula gradually appeared on the ulceration. The biopsy specimens from the base of the crater showed disarrayed cigar-shaped cells and those from the margin of the crater revealed infiltration of candida in the gastric mucosa, suggesting gastric candidiasis complicating leiomyoma of the stomach. Oral amphotericin B discontinued because of the side effects and intravenous miconazole was not effective. Endoscopic injection therapy with miconazole was started and after 11 sessions of the treatment (miconazole total 1, 700 mg), the ulceration and yellow-white protrusion disappeared. This is the first reported case of gastric candidiasis complicating leiomyoma of the stomach. Endoscopic miconazole injection is safe and effective for localized gastric candidiasis.