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Development of white globe appearance lesions in the noncancerous stomach after vonoprazan administration: a report of two cases with a literature review

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Abstract

White globe appearance has recently been identified as a novel endoscopic marker useful in the diagnosis of early gastric cancer. Recently, this lesion has also been reported in the noncancerous stomach, including cases with autoimmune atrophic gastritis, although the clinical significance remains unclear. We present the details of a 68-year-old woman who began vonoprazan therapy for severe gastroesophageal reflux disease causing esophageal stricture. On follow-up endoscopy 1 year after beginning vonoprazan, multiple white globe appearance lesions developed in all sections of her stomach, except for the antrum. We also detected lesions during a yearly follow-up in the noncancerous stomach of a 70-year-old man who had received vonoprazan for 3 years. Lesions in both cases constituted cystic gland dilatations containing eosinophilic material. There was no evidence of accompanying autoimmune atrophic gastritis in either patient. This report is the first to our knowledge describing newly developed white globe appearance lesions in the noncancerous stomach during follow-up in two cases who received vonoprazan. Our findings suggest that these lesions in the noncancerous stomach might be associated with vonoprazan treatment. We investigated the two cases endoscopically and histologically, and we report our findings with a literature review.

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Authors and Affiliations

  1. Division of Internal Medicine, Hiratsuka Gastroenterological Hospital, 3-2-16 Nishiikebukuro Toshima-ku, Tokyo, 171-0021, Japan

    Wataru Miwa & Takashi Hiratsuka

  2. Division of Surgery, Hiratsuka Gastroenterological Hospital, Tokyo, Japan

    Ken Sato

  3. Department of Cancer Genomic Medicine, Saitama Medical University International Medical Center, Saitama, Japan

    Takashi Fujino

  4. Division of Pathology, Hiratsuka Gastroenterological Hospital, Tokyo, Japan

    Yo Kato

Authors
  1. Wataru Miwa
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  2. Takashi Hiratsuka
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  3. Ken Sato
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  4. Takashi Fujino
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  5. Yo Kato
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Correspondence to Wataru Miwa.

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Wataru Miwa, Takashi Hiratsuka, Ken Sato, Takashi Fujino and Yo Kato declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Miwa, W., Hiratsuka, T., Sato, K. et al. Development of white globe appearance lesions in the noncancerous stomach after vonoprazan administration: a report of two cases with a literature review. Clin J Gastroenterol 14, 48–58 (2021). https://doi.org/10.1007/s12328-020-01243-z

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  • DOI: https://doi.org/10.1007/s12328-020-01243-z

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