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Stomach and Intestine(Tokyo) Volume 8, Issue 10 （October 1973）

胃と腸 8巻10号（1973年10月発行）

Japanese English

症例

Ⅰ型早期胃癌と細網肉腫とが同一胃に相接して共存した1例 A Case of Collision Tumor in the Stomach 石河勝 ¹ , 柴田醇 ¹ , 武暁 ¹ , 藤井信 ¹ , 三村征四郎 ² , 林茂夫 ² , 松尾洋二 ² , 岸川秀実 ² , 松浦康彦 ³ , 荒木文雄 ⁴ M. Ishikawa ¹ , J. Shibata ¹ , S. Mimura ² , K. Kishikawa ² , Y. Matsuura ³ , F. Araki ⁴ ¹国立岩国病院内科 ²国立岩国病院外科 ³国立岩国病院放射線科 ⁴国立岩国病院病理科 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

発行日 1973年10月25日 Published Date 1973/10/25

DOI https://doi.org/10.11477/mf.1403108494

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Abstract 文献概要
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　Borrmann Ⅰ型の診断のもとに胃切除術を施行し，組織検査の結果，胃前庭部にⅠ型早期胃癌と細網肉腫とが相接して共存し，その一部は衝突腫瘍の像を呈し，これらの病変と独立して胃角部にⅡc型早期胃癌，胃体中部にⅡb型早期胃癌を合併した稀有な1例を経験したので報告する．

　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.