化学療法ならびに放射線療法で著明な変化を示した胃原発性重複細網肉腫の1例

Double Reticulum Cell Sarcoma of the Stomach Changed Significantly by Chemotherapy and Radiationtherapy

　胃悪性リンパ腫は胃癌に比し放射線治療や化学療法によく反応するだけに，術前に正確な診断を下すことは，適切な治療方針を決定するにあたって大切なことと言える．

　われわれも術前に胃原発性重複細網肉腫との確診を得たが，開復術によって切除不能と判明したので保存的療法を施行し，興味ある効果像ならびに経過を観察できた症例を経験したので報告する．

　A 66-year-old woman admitted to our hospital with chief complaints of fatigue and anorexia on May 8, 1978.

　An x-ray examination of the upper gastrointestinal tract revealed two lesions in the cardia (Borrmann 3 type) and the anterior wall of the corpus (Borrmann 2 type) of the stomach. An endoscopic exaurination disclosed two completely separated lesions with natures of submucosal tumor. Biopsy and cytological examinations were performed, and she was diagnosed histologically as having reticulum cell sarcoma.

　Because of far advanced cardiac lesion, the operation had only been simple probe laparotomy. Chemotherapy was carried out. As the result of chemotherapy, Borrmann 2 type legion of the anterior wail of the corpus became a scar which looked like a benign ulcer, but stenosis of the distal portion of the esophagus occured after one month of chemotherapy. Radiotherapy (total 2,000 rad) was performed for the cardiac lesion. Although she had subjectively a remission, she died of dysphagia and general weakness five months after the radiotherapy.