Menetrier’s disease: report of three cases and a review of the literature

Abstract

Introduction Menetrier’s disease (MD) is an uncommon entity characterised by massive foveolar hyperplasia of the gastric mucosa, typically confined to the gastric body and associated with hypoalbuminaemia, and carrying an increased risk of malignancy. Nevertheless, no diagnostic criteria for the disease have been established since Menetrier’s description in 1888, and its aetiology remains unclear. Aims and Methods Gastrectomy specimens from three recent cases of MD with differing clinical presentations were studied and their histopathological and clinical features reviewed. Discussion All three cases showed Menetrier-like features, with florid foveolar hyperplasia, cystic dilation of underlying glands and paucity of inflammation, sometimes including the antrum. No Helicobacter were identified in any of the cases. One patient had intramucosal adenocarcinoma, and another had a long history of ulcerative colitis. Recently, transforming growth factor (TGF) α has been implicated in the genesis of MD. As TGFα shares a receptor with epidermal growth factor, a trial of the EGFR inhibitor cetuximab was attempted in one patient, with limited clinical benefit. Current knowledge of MD will be reviewed, using the three cases to highlight diagnostic and clinical features of this rare disease.