断端縫合部の進行癌の1例

Gastric Stump Carcinoma of the Lesser Curvature Following Billroth Ⅰ Resection

症例（I-19y-A）

　患　者：51歳，男．

　既往歴：1960年10月，胃下垂で手術（B-1法）．

　家族歴：父が胃癌で死亡．

　現病歴：1979年11月，健康診断で異常を指摘され，12月に当院入院．自覚症状はない．

　An asymptomatic 51-year-old man was admitted to our hospital with an abnormality of the stomach detected at a gastric mass survey. He had undergone Billroth Ⅰ resection 19 years earlier for gastroptosis. A barium meal study showed a nodular mass overlying the suture of the gastric stump. There was no evidence of obstruction of the stoma. At gastroscopy, an irregularly shaped nodular tumor with spotty whitecoated surface was well observed on the lesser curvature. The patient underwent radical gastrectomy.

　Macroscopic survey of the resected specimen showed a polypoid cancer measuring 5.0×3.5 cm. Histologically, mucocellular . adenocarcinoma invaded the submucosa.

　In the morphological analysis of our 12 lesions and 73 reported lesions of a primary postgastrectomy carcinoma, after Billroth Ⅱ resection it is commoner at the site of anastomosis, while after Billroth Ⅰ operation it is oftener seen at the suture.