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A Case of Ⅱc+Ⅲ+Ⅱb Type Early Gastric Cancer First Suspected as Multiple Gastric Ulcer K. Ikeda 1 , S. Ikejiri 1 , T. Ota 1 , H. Murakami 1 , J. Naramoto 2 1Dept. of Surgery Fukuoka Saiseikai General Hospital 22nd Dept. of Pathology, School of Medicine, Kurume University pp.1219-1225
Published Date 1972/9/25
DOI https://doi.org/10.11477/mf.1403109157
  • Abstract
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 The patient is a 66-year-old man. His chief complaint is postprandial pain in the epigastrium. He visited our hospital for thorough check-up because of the above symptom he had felt since about one month before. The initial fluoroscopy and gastroscopy disclosed an active ulcer on the anterior wall of the lower corpus associated with an ulcer scar in its greater curvature side. Several mucosal folds were also seen to converge toward the center of the scar. He was then placed under observation because the clinical course of the disease as well as various examinations failed to suggest any active malignancy. However, at the second fluoroscopy and endoscopy done about 40 days later we suspected that the lesion on the anterior wall of the lower corpus could have been a manifestation of a malignant cycle of early ulcercancer. Gastric biopsy confirmed our suspicion : it was group Ⅳ. Gastric resection was accordingly performed.

 Both macroscopic findings and histopathological diagnosis showed it to be a Ⅱc+Ⅲ+Ⅱb early cancer. Carcinomatous infiltration was more extensive and complicated than we had anticipated before the operation. It was because x-ray and endoscopy both failed to accurately visualize not only papillar elevation within the Ⅱc lesion but adjoining Ⅱb part as well. Of added interest was this elevation was histologically recognized as pseudo-papillar hyperplasia of tubular adenocarcinoma.

 The case here described shows that early gastric cancer, especially of depressed varieties, does often simulate benign ulcer. Even multiple benign ulcers may harbor malignancy within them, so that their energetic follow-up should not be neglected.


Copyright © 1972, Igaku-Shoin Ltd. All rights reserved.

基本情報

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

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