術前の深達度診断を誤ったⅠ＋Ⅱc型早期胃癌（深達度sm）の1例

Early Gastric Cancer, Type Ⅰ+Ⅱc (sm), Misdiagnosed for the Depth of Infiltration Preoperatively, Report of a Case

症例

　患　者：51歳，女，無職．

　主　訴：胸がつかえる感じと食欲減退．

　家族歴：特記すべきことはない．

　既往歴：30歳のとき軽度の妊娠中毒症に罹患したほか，特記すべきことはない．

　現病歴：1979年11月に感冒に罹患して近医を受診し投薬を受けたが，そのころから胸がつかえる感じと食欲減退があったため，同医にて胃X線検査を受けた．その結果，胃の中央部に米粒大の陰影があると言われ，同医のもとで内視鏡検査を受けて，手術を勧められた．1979年12月17日に，癌研内科を受診し，1980年3月21日に入院した．入院までの5カ月間に約6kgの体重減少を認めた．

　A case of 51-year-old woman with chief complaint of dysphagia and loss of appetite is presented.

　The radiologic diagnosis of pm cancer was based upon the following reasons.

　1) The well-defined depression around the rounded protruded lesion seemed to be infiltrating to sm.

　2) The rounded protruded lesion was suspected to be the result of mucosal elevation caused by cancerous infiltration to pm.

　3) The lower protruded lesion at the anal side of it was thought to be infiltrating to sm because of the surface with many erosions and granurality.

　Endoscopically the lesion was recognized as polypoid cancer, but diagnosis of depth of cancer infiltration was not made strictly.

　The resected stomach revealed early gastric cancer, type Ⅰ+Ⅱc, infiltrating to sm with invasion to submucosal lymphatic vessels (ly 2).

　Histological examination revealed metastasis to lymph node (n₂), and operation resulted in relative curative resection.