Metastatic gastric adenocarcinoma associated with hypertrophic gastropathy resembling Ménétrier's disease in an adult Labrador Retriever dog

We describe a case of hypertrophic gastropathy (Ménétrier’s like disease) with metastatic gastric adenocarcinoma in a seven-year-old intact female Labrador Retriever dog. The animal suddenly presented with emesis and died. Gross lesions included a marked diffuse thickening of the gastric mucosa and an ulcerated transmural neoplastic mass in the gastric body. Gastric body and fundus were affected by foveolar hyperplasia with loss of chief and parietal cells replaced by mucous cells and marked dilatation of gastric glands. An area of gastric adenocarcinoma with submucosal lymphatic vessels invasion was also present and metastases were observed in the gastric lymph nodes, small intestine, pancreas, lung and liver. Due to its similarity with other gastric proliferative disorders, including this condition in the list of differentials is a necessary step in the diagnostic investigation of canine gastropathies.

A Misdiagnosed Case of Hypertrophic Gastropathy

Hypertrophic gastropathy is a rare idiopathic hyperproliferative disorder which may present as Menetrier’s disease (MD) characterized by foveolar hyperplasia in the gastric fundus and body. It is often accompanied by a severe loss of plasma proteins (including albumin) from the altered gastric mucosa. The disease occurs in two forms, a childhood form due to cytomegalovirus infection and an adult form attributed to overexpression of transforming growth factor-alpha (TGF-α). The most common symptoms include epigastric pain with fullness and vomiting and generalized peripheral edema with hypoalbuminemia. We present a case of 75-year-old female presenting with epigastric pain and vomiting. Upper gastrointestinal endoscopy and computed tomography scan revealed an irregular mucosal fold at the body and antrum and thickening of the stomach wall, respectively. Though the endoscopic gastric mucosal biopsy was nonspecific, the patient underwent partial gastrectomy due to clinicoradiological suspicion of carcinoma. On histopathology, the case was reported as hypertrophic gastropathy, consistent with MD. Though there is a strong clinical and radiological suspicion of malignancy in the hypertrophied gastric mucosa, MD should be one of the important differential diagnoses.