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術前進行癌と診断されたsm胃癌の1例を経験したので,若干の考察を加え報告する.
症例
患 者:53歳,女,銀行員.
現病歴:1976年3月,集団検診で要精密検査と言われ,同年4月23日当院を受診した.
A 53-year-old woman had mass screening examination for the stomach and was recommended to have further examination.
UGI series and endoscopy showed an irregularly shaped depression on the greater curvature in the antrum. We thought this lesion was Ⅱc type advanced cancer because of remarkable swelling at the tip of the converging mucosal folds and hardness of the lesion.
On the resected stomach, macroscopically this lesion was advanced cancer. However, histological study revealed that cancer cells, which were composed of poorly differentiated adenocarcinoma, invaded only the submucosal layer, but the invasion was massive and very close to the proper muscle layer.
We think it is very difficult to differentiate cancer invading massively the submucosal layer from that invading the proper muscle layer.
In the future, we intend to evaluate strictly the depth of invasion and whether or not that is meaningful in our clinic.
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