The natural history of hypertrophic gastrophy (Menetrier's disease). Report of a case with 16 year follow-up and review of 120 cases from the literature.

We describe a 33 year old man who presented with epigastric pain, weight loss and hematemesis. Roentgenograms of the upper gastrointestinal tract and endoscopy demonstrated giant rugal folds, and the diagnosis of hypertrophic gastropathy was confirmed by operative biopsy. This patient's symptoms and abnormalities noted on the roentgenograms persisted until his death 16 years later. Postmortem examination confirmed the persistence of hypertrophic gastropathy and revealed, in addition, a hepatocellular carcinoma metastatic to the stomach and regional lymph nodes. A review of 120 previously reported cases of hypertrophic gastropathy with special attention to its natural history indicates that the chronic nature of this patient's illness is typical. In addition, the chance of gastric carcinoma developing in these patients is appreciable. Since the reported long-term results of operative therapy appear favorable, patients with persistent and sufficiently distressing symptoms should be considered for gastric resection.