Gastric Adenocarcinoma in a Patient with X-Linked Agammaglobulinemia and HIV: Case Report and Review of the Literature

Patients with primary immunodeficiency are at an increased risk of cancer. Our case and literature review indicate an association between X-linked agammaglobulinemia and gastrointestinal malignancy and suggest that screening for gastrointestinal malignancy should occur for patients with X-linked agammaglobulinemia and gastrointestinal symptoms, unexplained anemia, or atrophic gastritis. X-linked agammaglobulinemia (XLA) is an X-linked inherited disease caused by a germline mutation in the BTK gene leading to Bruton’s tyrosine kinase deficiency, which results in the impaired development of B-lymphocytes and a subsequent lack of immunoglobulin production. Patients with XLA have an increased susceptibility to bacterial and viral infections, and multiple case reports have been published regarding an association between XLA and gastrointestinal (GI) malignancy. Here, we describe a case of a 25-year-old man with XLA and HIV, who developed gastric adenocarcinoma. Previously reported cases of XLA and GI malignancy are also reviewed and summarized.