A Minute Early Gastric Cancer on Leiomyoma at the Esophago-gastric Junction N. Hayakawa 1 , S. Hichino 1 , T. Sato 1 , Y. Nimura 2 , N. Nakashima 3 1Dept. of Surg., Yachiyo Hospital 21st Dept. of Surg., Nagoya Univ., School of Medicine 3Dept. of Clinicalpathology, Nagoya Univ. Hospital pp.1075-1080
Published Date 1978/8/25
DOI https://doi.org/10.11477/mf.1403107404
  • Abstract
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 The patient was a 59-year-old woman with a chief complaint of chest pain.

 The gastric lesion was suspected with the chest X-ray examination at her first visit to our hospital. Subsequent barium meal X-ray examination revealed a submucosal tumor at the cardiac region of the stomach. An irregular-shaped red spot was found with endoscopy on the gastric anterior side of the tumor close to its central pit. The biopsy specimen from this spot was found to be adenocarcinoma. Laparotomy performed on March 11, 1975, showed a tumor close to the greater curvature at the esophago-gastric junction. The size of this tumor was 35 X 20 X 15 mm and a shallow depression, 5 X 15 mm in diameters, was found on it. Microscopic examination of this tumor revealed leiomyoma and that of the depression tubular adenocarcinoma, which spread under the esophageal mucosa.

 Although 10 cases of minute early gastric cancer at the esophago-gastric junction have been reported, all were of elevated type. Our case is the first of depressed type. Furthermore, the presence itself of early gastric cancer on leiomyoma is rare.

 While we failed to diagnose this case as a gastric cancer with X-ray examination, endoscopy and subsequent biopsy was useful. The endoscopic examination could be superior to the X-ray examination when the gastric lesion is extremely small.

Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.


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