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A Case of Early Gastric Cancer Associated with Ménétrier's Disease M. Nomura 1 , H. Hirabayashi 1 , T. Kiyama 1 , Y. Takehara 1 1Kanto-chuo Hospital pp.83-87
Published Date 1972/1/25
DOI https://doi.org/10.11477/mf.1403108977
  • Abstract
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 Case: a 50-years-old male. The patient visited our clinic because of dull pain in the stomach when it was empty and nausea he had felt since six months before. No loss of weight. No abnormality was seen in the physical examination. Laboratory examinations were normal except for low serum protein level (5.5 g/dl). Gastric juice was of normal acidity.

 X-ray findings: The mucosal relief from the corpus to the angle was very much broadened and twisted.

 Endoscopic findings: No malignant picture was seen on the giant rugae from the corpus to the angle, but a fairly large Ⅱc lesion was found between the angle and the lesser curvature of the antrum.

 Biopsy was positive for cancer. Diagnosis: gastric cancer. However, it was not clarified whether there was any cancer invasion into the submucosa of the enlarged folds.

 Gross findings of the removed stomach: The gastric corpus as a whole was a mass of markedly broadened mucosal folds. They were meandering and convolutional. The mucosal folds on the anterior wall measured 1.5~2.0 cm both in height and breadth. Below these broadened folds was seen a Ⅱc lesion, measuring 6.0×5.0 cm, on the lesser curvature of the antrum.

 Histological findings: Adenocarcinoma tubulare intermixed with carcinoma mucocellulare was seen in a site almost corresponding to the area of cancer macroscopically diagnosed as such. Its depth invasion was chifly m with partial sm involvement. The broadened mucosal fold were due to (1) epithelial hyperplasia of the gastric pits, (2) hyperplasia of pseudopyloric glands, (3) marked cystic formation in the deeper part of the mucosa as well as in the submucosa and (4) distortion and fibrosity of the lamina propria together with round cell infiltration. Of these, the first and the third were most responsible for giant folds. Most of these folds were free from cancer except a small area adjoining the Ⅱc, where cancer was recognized in the mucosa.

 Association of Ménétrier's disease with early gastric cancer is of such a rare occurrence that only three cases have been reported so far. Although causal relation between the two is as yet unknown, clinically it is to be remembered that gastric cancer can at times be associated with benign giant mucosal folds.


Copyright © 1972, 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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