Menetrier's disease and adenocarcinoma of the pancreas

A 74-year old woman with abdominal pain and edema was diagnosed to have Menetrier's disease on surgical full thickness gastric wall biopsy. Two months later, she complained of increasing severe abdominal pain radiating to the back, unusual in Menetrier's. Work-up showed classic Menetrier's disease with large gastric folds, achlorhydria, gastrointestinal protein loss and hypoalbuminemia. A celiac arteriogram, however, suggested a pancreatic neoplasm and adenocarcinoma of the body of the pancreas was confirmed at laparotomy. This is the first report of the concurrence of these two diseases. The difficulty of differentiating Menetrier's from occult gastrointestinal cancer is discussed.