6年8ヵ月にわたり追跡した83歳男性胃癌の1例

Gastric Carcinoma of 83-year-old Man Followed Up for Six Years and Eight Months, Report of a Case

　胃癌の発育経過の経時的観察は疾患の性質上，特殊な場合を除いてretrospective studyによるか，多数例の組み合わせによる推測によるなど，不完全な資料によらざるを得ない．今回，早期の状態で発見された胃癌が患者の健康状態より手術を行わず，6年8カ月にわたりその経過を観察することができ，その間にこのような経過観察でなくては知ることのできない興味ある病像の変化が認められたので，その症例について報告する．

　A 76-year-old man, in his treatment for bronchial asthma, was found to have early gastric cancer, type Ⅱa+Ⅱc-like on the greater curvature of the antrum. The histological diagnosis was adenocarcinoma tubulare. No operation was performed on account of pulmonary functional disturbance and advanced age and no anticancer agent was given.

　The lesion gradually enlarged after three years and ten months to progressive type Ⅱa. About seven months later the tumor suddenly enlarged and was found to be type 1 of Borrmann's classification. Within a year the tumor disappeared leaving behind an ulceration to form Borrmann 2. Thereafter the lesion spread slowly. About six years and four months after diagnosis was made he was admitted because of abdominal fullness sensation. The patient then died six years and eight months after its diagnosis as gastric cancer.

　The growth of cancer in this case revealed periods of slow and abrupt progress. The symptom was abdominal fullness sensation due to ascites. The fluid was transudate and no cancer cells were found. The patient was normal in his daily life till hospitalization and died four months later at the age of eighty three.