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A Case of Metastatic Carcinoma of the Stomach in a Young Girl Simulating Gastritis Erosiva in X-ray and Endoscopic Findings M. Mai 1 , H. Morita 1 , K. Watanabe 2 , A. Mukawa 2 , K. Yamato 3 1Dept. of Surgery, National Kanazawa Hospital 2Dept. of Pathology, National Kanazawa Hospital 3Kanazawa City pp.1209-1215
Published Date 1972/9/25
DOI https://doi.org/10.11477/mf.1403109155
  • Abstract
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 A case of metastatic carcinoma of the stomach is described which on the x-ray and endoscopic findings showed a very close resemblance to so-called gastritis erosiva or verrucosa, one of recent topics in the modern gastric diagnostics.

 The patient is a 22-year-old female who underwent right colectomy about two years ago because of primary carcinoma of the transverse colon. Histologically, the tumor consisted of mucocellular nodular tissue which invaded the entire wall with regional lymph node metastases. The stomach was free from any abnormality then.

 The postoperative course was uneventful and the patient remained well until two years and three months later when she revisited the hospital complaining of dull epigastric pain. X-ray and endoscopy of the stomach revealed a lesion, 4.4×4.5 cm, on the anterior wall of the antrum in addition to multiple small nodules spreading almost all over the stomach. Both lesions were centrally depressed, showing characteristic pictures of so-called gastritis verrucosa. The patient was followed up under that tentative diagnosis.

 Re-examination of the stomach about two months later disclosed multiple small nodules increased in number as well as in size. Endoscopic biopsy taken from both lesions revealed signet-ring cell carcinoma. Laparotomy was accordingly performed. Although the serosal surface of the stomach was smooth, many metastatic lymph nodes were palpable in the omentum and mesentery. One of the small nodules in the stomach resected for pathological examination disclosed signet ring cell carcinoma involving both the mucosa and submucosa. The tumor was sharply demarcated against the adjacent intact mucosa with no signs of cellular reaction or glandular metaplasia. Alcian blue-PAS stained sections of the stomach nodule showed the same staining of mucinous carcinoma cells as those of the primary tumor of the colon, so that the former was diagnosed as metastasis from the latter. The patient, treated with chemotherapy, is now under observation for three months after laparotomy.

 Because of no documented case of this kind reported so far in the literature, emphasis is laid on a rsemblance of this special case to gastritis verrucosa in the x-ray and endoscopic findings. This fact may contribute to the differential diagnosis of similar lesions.


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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