A Case of Early Gastric Cancer Simultaneously Diagnosed with the Onset of Microscopic Polyangiitis

Abstract

A 71-year-old woman presented with a one-month history of high fever. Proteinuria and urine occult blood were detected by precise examinations and a renal biopsy revealed microscopic polyangiitis. Simultaneously, early gastric cancer was detected with a screening gastrointestinal endoscopy. Robot-assisted distal gastrectomy with D1+ lymph node dissection was performed following an introduction of immunosuppressive therapy against microscopic polyangiitis. Several previous reports suggested that malignant disease might be involved in the development of anti-neutrophil cytoplasmic antibody-related vasculitis including microscopic polyangiitis. However, in many cases, vasculitis developed after as long as several years from the diagnosis of malignant disease, and most cases were of hematologic malignancy. In this case, microscopic polyangiitis and gastric cancer were simultaneously diagnosed. This case was valuable to consider the relevance between malignant disease and vasculitis development. Moreover, the timing and method of surgery for malignant disease are important not to make vasculitis worse.