Introduction
Lanthanum
carbonate is one of the widely used
phosphate
binders, which are orally taken to reduce
serum
phosphate levels in dialysis patients with chronic kidney
disease.1Lanthanum
carbonate binds to dietary phosphate and forms insoluble complexes and
is excreted in feces, but recently
lanthanum
carbonate deposition in the gastric and duodenal mucosa has been
reported in patients taking them.2-8 In previous
studies, the findings of lanthanum deposition with endoscopy in gastric
mucosa, white lesions, elevations, erosions, and ulcerations have been
usually described in the gastric mucosa. Pathologically, lanthanum
depositions usually appear as subepithelial collections of histocytes or
small foreign body granulomas, accompanied by intestinal metaplasia,
regenerative changes, and foveolar hyperplasia.1,9-11Although some studies have reported that lanthanum deposition and
subsequent mucosal changes potentially induce neoplastic lesions, the
relationship between lanthanum deposition and carcinogenesis is
unknown.11,12
There are few reports of gastric cancer concurrent with lanthanum
deposition2,12-14 and surgical resection of gastric
cancer concurrent with lanthanum deposition.2,12Furthermore, unlike past resected cases, in this case, it was difficult
to clearly distinguish gastric adenocarcinoma from mucosal changes
because of its confusing appearance following lanthanum deposition.