Small Cardiac Cancer Developing into Advanced Cancer within a Short Period after Endoscopic Mucosal Resection, Report of a Case Taiji Akamatsu 1 , Kenji Mukawa 1 , Hiroyasu Ushimaru 2 , Tsutomu Owa 2 , Kendo Kiyosawa 2 1Department of Erzdoscopy, Shinshu University School of Medicine 2The Second Department of Internal Medicine, Shinshu University School of Medicine Keyword: 内視鏡的粘膜切除術 , 早期胃癌 , 遺残・再発 , 再治療 , 噴門部癌 pp.1129-1132
Published Date 1996/8/25
DOI https://doi.org/10.11477/mf.1403104229
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 A 86-year-old male was admitted to Shinshu University Hospital in September, 1990 for the purpose of endoscopic treatment for small cardiac cancer. He had been suffering from pulmonary tuberculosis and emphysema. A small Ⅱc type gastric cancer on the posterior of the cardiac region was resected using the procedure of endoscopic mucosal resection (EMR) using a 2-channel scope of straight-view type. Histopathologically, well or moderately differentiated adenocarcinoma with high atypia was limited to within the mucosa, but the resected margin could not be evaluated because of heat degeneration by the high-frequent current. Follow-up endoscopy after one month following the EMR revealed local recurrence. It was treated by cauterization with high-frequent current. Local rerecurrence was repeatedly recognized after three and five months. We considered surgical gastrectomy, but the patient was judged to be unable to tolerate such an operation because of respiratory dysfunction and high age. Reluctantly we repeated endoscopic re-treatment, but the residual cancer rapidly enlarged and developed into a 2 type advanced cancer eight months after the first endoscopic treatment.

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