Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2015; 7(11): 369-374
Published online Nov 15, 2015. doi: 10.4251/wjgo.v7.i11.369
Does St. John’s Wort cause regression in gastrointestinal system adenocarcinomas?
Serap Karaarslan, Suna Cokmert, Atilla Cokmez
Serap Karaarslan, Department of Pathology, Sifa University Faculty of Medicine, 35100 Izmir, Turkey
Suna Cokmert, Department of Medical Oncology, Sifa University Faculty of Medicine, 35100 Izmir, Turkey
Atilla Cokmez, Department of General Surgary, Sifa University Faculty of Medicine, 35100 Izmir, Turkey
Author contributions: All authors contributed to this case report.
Institutional review board statement: Institutional Review Board statement was waived because of the retrospective characteristics of this report.
Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to case reports enrollment.
Conflict-of-interest statement: We declare that we have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Serap Karaarslan, MD, Associate Professor, Department of Pathology, Sifa University Faculty of Medicine, Sanayi Caddesi No. 7, Bornova, 35100 Izmir, Turkey.
Telephone: +90-232-3434445 Fax: +90-232-3435656
Received: March 4, 2015
Peer-review started: March 10, 2015
First decision: May 19, 2015
Revised: August 1, 2015
Accepted: September 10, 2015
Article in press: September 16, 2015
Published online: November 15, 2015

St. John’s Wort (SJW) is an old herb which has long been consumed widely for its anti-inflammatory, antiviral, and anti-depressive properties. Here we present a detailed clinical evaluation of three cases (two colon and one duodenal adenocarcinoma) with remarkable and intensive lymphoplasmocytic host reaction, at the basal part of tumor, intensive fibrosis, giant cells, plasma cell increase in lymph nodes and few giant cells in germinal centers in resection specimens. The observation of similar host reaction in those tumors having otherwise usual appearance was interesting. None of the cases received neoadjuvant chemoradiotherapy or additional treatment before surgery but only SJW. These cases are presented to increase the awareness about such cases. Further research is needed to reveal the possible effect of SJW, which has long been consumed for different treatment purposes, on human tumors.

Keywords: St. John’s Wort, Adenocarcinoma, Giant cell

Core tip: St. John’s Wort (SJW) is a well known herb that was used in treatment of many diseases during centuries. In this article we offer a perspective about the anti-tumoral effect of SJW with possible mechanisms and pathological data in three gastrointestinal cancer cases, where usage of SJW was identified in history questioning because of tumor regression and intensive inflammatory host reaction following pathological examination.