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A Case of Intramucosal Cancer of the Stomach followed up for 2 Years and 3 Months considered to have followed the Malignant Cycle T. Kamada 1 , K Shiomi 1 , M. Honjo 1 , H. Miura 1 , Y. Mukaide 1 12nd Dept. of Internal Medicine, Hirakata City Hospital pp.773-780
Published Date 1976/6/25
DOI https://doi.org/10.11477/mf.1403107296
  • Abstract
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 A case of early gastric cancer is described which was considered to have followed a malignant cycle, ulcer recurring four times (Fig. 1). This case was followed up for as long as 2 years and 3 months, examined in between 13 times by x-ray and 14 times by endoscopy.

 The patient, a 34-year-old woman, with a chief complaint of pain in the upper abdomen visited us for medical workup. The initial x-ray (Fig. 2) and endoscopy (Fig. 3) revealed an ulcer-like lesion, measuring 1.5×1.0 cm, on the lesser curvature above the angle. One month later scarring of the lesion was demonstrated (Fig. 4). Subsequently ulcer reurredc four times (Figs. 5~18). Biopsy was performed at the 13 th endoscopy(Fig. 19). A diagnosis of a Ⅱc lesion was followed by surgical intervention.

 Retrospective study indicated that biopsy should have been done at the initial endoscopy (Fig. 3) with a suspicion of malignancy, because there had been a shallow depression around the ulcer-like lesion along with club-like swelling and interruption of the mucosal folds coming from the posterior wall. Furthermore, a diagnosis of Ⅱc ought to have been made during the scarring stage in the course of follow-up because shallow depression and tapering of the mucosal folds were revealed by x-ray and distinct fading of the mucosal color was seen by endoscopy.

 Gross specimen of the resected stomach (Figs. 21, 22, 23) showed a shallow depression at the angle, measuring 3.0×3.0 cm. We were also able to trace a Ⅱc lesion, although it was not so clear-cut. Histologically it was adenocarcinoma mucocellulare. The degree of infiltration was m, Almost in the center of the lesion was seen an ulcer scar, Ul-Ⅲ, in which no cancer cells were demonstrated. There was no lymphnode metastasis.


Copyright © 1976, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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