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A Case of Early Gastric Cancer Showing an Interesting Course: From protruding lesion to Ⅱa+Ⅱc N. Nakatsugawa 1 , T. Wakabayashi 2 1Nakatsugawa Clinic 2Matsushita Health Administration Center pp.1451-1456
Published Date 1973/11/25
DOI https://doi.org/10.11477/mf.1403108443
  • Abstract
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 The course of gastric cancer has been often reported in the past, but relatively seldom has it been followed up for a long time. The present case is of interest because it has been under observation for as many as six years, regarded in all probability as an elevated lesion of benign nature, although from the outset it was not completely possible to rule out malignancy, the more so because we could not perform biopsy on account of the patient's refusal. In the interim the growth evoleved from a Ⅱa-like protrusion to cancer of deep penetrating type with features of Ⅱa+Ⅱc.

 The patient, a man aged 60, with no signs and symptoms referrable to the stomach, underwent minute examination of the stomach. Roentgenogram revealed a broad-based, well-defined protrusion, 13 by 10 mm, on the posterior wall of the antrum in the greater curvature side. Biopsy was proposed but was refused. We had to be content with examining him every 4 to 6 months only by x-ray and endoscopy. During the five years since the initial examination the growth remained hardly unaltered in its shape and size. Then, the protrusion grew rapidly low in stature, showing manifest changes suggestive of cancer infiltration into the submucosal layer. Over the years the patient had been urged to undergo biopsy, and after the distinct change of the tumor surgical intervention was advised, but after all it took more than another one year before he consented to the operation. Pathologically, it was papillary adenocarcinoma, as yet in the stage of early cancer of deep penetrating type, its invasion mostly localized in the submucosal layer. Presumably it had remained early cancer of m invasion during the first five years. Perseverance of the examiner and the refusal of the patient led up to an invaluable example of 6-year-long observation of a developing pattern of gastric cancer.


Copyright © 1973, 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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