A Case of Collision Tumor in the Stomach M. Ishikawa 1 , J. Shibata 1 , S. Mimura 2 , K. Kishikawa 2 , Y. Matsuura 3 , F. Araki 4 1Dept. of Internal Medicine, Iwakuni National Hospital 2Dept. of Surgery, Iwakuni National Hospital 3Dept. of Radiology, Iwakuni National Hospital 4Dept. of Pathology, Iwakuni National Hospital pp.1355-1359
Published Date 1973/10/25
DOI https://doi.org/10.11477/mf.1403108494
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 A collision tumor, reticulum-cell sarcoma colliding with early gastric cancer of type I, was found in the stomach of 58-year-old man, coexisting with multiple early gastric cancers in the upper part of the same stomach.

 The patient was admitted to the hospital because of general fatigue and upper abdominal discomfort. Both x-ray and endoscopic examinations revealed a tumor of Borrmann type I in the anterior wall of the antrum. Subtotal gastorectomy with resection of local lymphnodes was performed.

 On resected specimen, antral tumor, which was diagnosed preoperatively as Borrmann type I, was found to have two components: reticulum-cell sarcoma in the oral portion of the tumor and early gastric cancer of type I in the anal portion. The reticulum-cell sarcoma measuring 1×1. 5 cm was located mainly in the submucosal layer and only a small portion was intramucosal. The gastric cancer was adenocarcinoma of papillotubular type and invaded into submucosal layer. Two components were separated in large portion but in small portion they were conformed to be met with each other.

 There also found other two early gastric cancers in the same stomach, which had been overlooked both by radiologists and endoscopists. One is IIc type measuring 2×4 cm, located in the angle and of adenocarcinoma tubular type, with the infiltration only in mucosal layer. The other is the IIb type, located in the posterior wall of mid-corps and of adenocarcinoma tubular type, part of which probably remained unresected on operation.

 Metastasis of sarcoma was found on two of seven resected lymphnodes but metastasis of cancer was not. The patient died nine months after operation in cachectic state. Autopsy revealed metastasis of reticulum-cell sarcoma in many organs, such as esophagus, liver, spleen and lymphnodes, but nowhere was found the metastatis of cancer.

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