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A Borrmann Type 1 Gastric Cancer Misdiagnosed in Its Depth of Invasion, Report of a Case Y. Ohsaki 1 1Department of Internal Medicine, Cancer Institute Hospital pp.545-550
Published Date 1982/5/25
DOI https://doi.org/10.11477/mf.1403108906
  • Abstract
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 The patient was a 46-year-old man with no particular complaints. Preoperatively he was diagnosed as having Ⅱa type early gastric cancer with m invasion depth, but after the operation histological study demonstrated that cancer invaded the submucosal layer like a mass. Roentgenographycally, a line of slightly irregular contours, measuring 15×13 mm, was seen on the lesser curvature of the mid-body. On its surface was recognized a small, pale shadow fleck. Endoscopy revealed that this protruded lesion was rather flat and its margins were mostly smooth, but it was raised relatively sharply from the base. The tip of the lesion was easy to bleed. By both x-ray and endoscopy the lesion was diagnosed as Ⅱa type early cancer and the depth of invasion was estimated as m. Radical operation: R2 (N0H0P0S0) was performed at the Department of Surgery, Cancer Institute Hospital, Tokyo. The resected specimen showed an almost round and flat elevation, measuring 15×13 mm, on the lesser curvature of the mid-body. The contours were slightly irregular with faintly reddened surface. There was no ulcer. The mucosal surface of the protrusion hardly differed from that of the surrounding mucosa. Histologically the lesion was adenocarcinoma papillotubulare, consisting of Ⅱa-like hyperplasia of cancer within the mucosa and massive infiltration in the submucosa. Re-investigation of the x-ray findings before the operation comparing with those of histologic specimens showed us a translucent area coinciding with that of deep infiltration in a film which depicted the lesion as a side view. Accordingly, we have realized the importance of side view of a lesion when we attempt to estimate the depth of infiltration in protruding lesions.


Copyright © 1982, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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