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Epstein-Barr virus (EBV) associated gastric cancer is a rare occurrence that was first reported in 1990 [1]. After a cancer episode, rapid development of an EBVaGC is extremely rare, with only one case previously recorded [2]. They are discussing the case of a male patient who developed EBVaGC after two months of adjuvant treatment for colon cancer. For one week, a 69-year-old male patient had tarry stool transit. The patient previous medical history was notable for the presence of transverse colon cancer after right hemi colectomy. T3N1M0 was the tumour stage, and that they had received adjuvant chemotherapy treatment months prior. The level of carcinoembryonic antigen in the serum was 8 ng/mL.

A pan endoscopic study revealed an ulcerative tumour in the stomach's middle body (Figure 1A). A tomography (CT) scan showed a 4-cm ulcerative tumour on the gastric body's anterior wall (Figure 1B). There was no evidence of colonic cancer recurrence on the local level. The patients received a subtotal gastrostomy after a stomach biopsy revealed malignancy. Tumor cells with vesicular nuclei and large nucleoli arranged in a syncytial pattern infiltrated the rich lymphoid background, as according histopathological findings in the stomach (Figure 1C; hematoxylin and eosin stain 400x). Pan-cytokeratin positivity was found in the cancer cells by immunohistochemistry. In situ hybridization of the Epstein-Barr encoding region was positive (Figure 1D), and EBVaGC was diagnosed.

Figure 1: (A) An ulcerative mass in the stomach's middle body. (B) A com puted tomography scan showed a 4cm ulcerative tumor on the gastric bo dy's anterior wall (arrow). (C) Histological features of cancer cells infiltrating the lymphoid background in a syncytial pattern (hematoxylin and eosin stain 400X). (D) Epstein -Barr encoding region in situ hybridization was positive in cancer cells (100X).

The patient is still doing well two years after the incident. EBVaGC is an uncommon type of gastric carcinoma with male predominance, a younger age than EBV-negative gastric carcinoma, and a propensity to arise in the proximal stomach region [3,4]. After a partial gastrostomy for benign gastric diseases, EBVaGC is linked to a higher incidence of multiple carcinomas at various sites in the stomach, as well as gastric remnant carcinoma status [4,5]. They illustrated the sequences of mucosal damage done by graft versus host illness, immunosuppression, and EBV reactivation that lead to carcinogenesis. In order to fully understand the mechanism, more such examples will need to be studied in the future.