Epstein-Barr virus (EBV)-associated gastric carcinoma accounts for nearly 10% of all gastric carcinomas and has distinct demographic, clinical and pathological features compared with EBV-negative gastric carcinoma. We herein report the case of a patient with EBV-associated gastric carcinoma followed up for 12 years during the natural course of the disease. The appearance of the tumor on gastroscopy and computed tomography gradually changed, and the size of the lesion increased very slowly during the 12 years, without metastasis. The present case indicates that some EBV-associated gastric carcinomas progress very slowly.

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