A 60-year-old male patient with advanced gastric adenocarcinoma was treated by subtotal gastrectomy with dissection of the regional lymph nodes. Microscopic examination of the tumour revealed tubular adenocarcinoma which invaded the muscularis propria. There was no evidence of metastatic carcinoma in the dissected lymph nodes (pT2N0Mx). Granulomatous reaction comprising epithelioid cells and giant cells involved subserosal muscular veins, adjacent to the carcinoma tissue. Fibrinoid necrosis, with or without infiltration of eosinophils, was noted within the lumen of some veins. The acid-fast and fungal stains were negative. Remnants of parasites were not identified in serial sections of the paraffin blocks. No pulmonary disease was evident on radiographic or pulmonary examination. The presence of granulomatous destruction of muscular veins with sparing of arteries suggested the diagnosis of giant-cell phlebitis. To our knowledge, there have been no previous reports regarding an association between giant-cell phlebitis and advanced gastric adenocarcinoma.
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