Hookworm Infection Mimicking Early Gastric Mucosal Carcinoma: Magnifying Endoscopy Findings in Two Cases

Background

Hookworms primarily parasitize in the intestinal tract, and the gastric involvement is extremely rare, which often leads to misdiagnosis. We present two cases of hookworm infection that mimicked early gastric carcinoma.

Case Summary

Two patients presented with clear boundaries gastric mucosa lesions exhibiting brownish discoloration, resembling early gastric mucosal cancer. Live hookworms were identified on the gastric mucosal surface using magnifying endoscopy combined with narrow-band imaging. Hookworm eggs were detected in both patients through fecal etiological evaluation. Following standard anthelmintic treatment, both the lesions and the worms resolved.

Conclusions

In the differential diagnosis of localized well-defined gastric mucosal lesions, parasitic infections should be considered in addition to neoplastic lesions. Magnifying endoscopy plays a critical role in distinguishing gastric mucosal lesions suspicious for parasitic infection.