{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:48:06Z","timestamp":1782899286220,"version":"3.54.5"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>\n                    Metabolic bariatric surgery (MBS) does not appear to increase the overall risk of gastric cancer; therefore, there are few documented cases of Epstein\u2013Barr virus\u2013associated gastric carcinoma (EBVaGC) arising early after single anastomosis sleeve ileal bypass (SASI). Here, we report a 62-year-old man who underwent SASI in July 2024 and remained asymptomatic on follow-up. Surveillance endoscopy at 12 months disclosed a 1.2 \u00d7 1.0\u00a0cm deeply excavated ulcer in the posterior gastric body; biopsy revealed adenocarcinoma with Helicobacter pylori negativity and imaging showed focal wall thickening. Indocyanine green\u2013guided laparoscopic radical gastrectomy demonstrated moderately to poorly differentiated EBVaGC with diffuse EBER\n                    <jats:italic>in situ<\/jats:italic>\n                    hybridization positivity, preserved mismatch repair protein expression, wild-type p53, and a high proliferative index (Ki-67 ~90%). Targeted sequencing identified an ARID1A truncating mutation (p.Y215*, VAF 4.56%) and CCND1 amplification (~6 copies). Plasma EBV and postoperative circulating tumor DNA minimal residual disease testing were negative (single ATR VUS at 0.10%). The patient recovered uneventfully and remained disease-free at 8 months. This case highlights the biologic plausibility of tissue EBV positivity despite negative plasma EBV in EBVaGC and supports a post-MBS evaluation strategy that incorporates EBER-ISH and molecular stratification for suspicious gastric lesions, with a lower threshold for diagnostic endoscopy in patients with persistent upper gastrointestinal symptoms or unexplained nutritional abnormalities; routine gastroscopic assessment at approximately 1 year after MBS may also be considered to evaluate remnant gastric mucosal health.\n                  <\/jats:p>","DOI":"10.3389\/fonc.2026.1873529","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:08:21Z","timestamp":1782896901000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["EBV-associated gastric carcinoma occurring one year after metabolic bariatric surgery: case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"YingXin","family":"Wu","sequence":"first","affiliation":[{"name":"Section for Gastrointestinal Surgery, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxi","family":"Yang","sequence":"additional","affiliation":[{"name":"Section for Gastrointestinal Surgery, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]},{"name":"Obesity and Metabolism Medicine-Engineering Integration Laboratory, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Wang","sequence":"additional","affiliation":[{"name":"Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjun","family":"Liu","sequence":"additional","affiliation":[{"name":"Section for Gastrointestinal Surgery, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]},{"name":"Obesity and Metabolism Medicine-Engineering Integration Laboratory, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]},{"name":"Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianqi","family":"Lu","sequence":"additional","affiliation":[{"name":"Section for Gastrointestinal Surgery, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]},{"name":"Obesity and Metabolism Medicine-Engineering Integration Laboratory, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]},{"name":"Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1038\/nrc.2016.92","article-title":"Epstein-Barr virus: more than 50 years old and still providing surprises","volume":"16","author":"Young","year":"2016","journal-title":"Nat Rev Cancer"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.7150\/jca.37282","article-title":"Epstein Barr virus associated lymphomas and epithelia cancers in humans","volume":"11","author":"Ayee","year":"2020","journal-title":"J 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