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A Minute Early Gastric Cancer of the Anterior Wall Seen in a Postapoplectal Patient K. Nagano 1 , K. Takagi 2 , Y. Yasuda 2 , M. Suzuki 2 , S. Moriya 3 1Dept. of Internal Med., Kyoaikai, Hospital 2Dept. of Surgery, Kyoaikai, Hospital 3Dept. of Inspection, Kyoaikai, Hospital pp.937-941
Published Date 1972/7/25
DOI https://doi.org/10.11477/mf.1403109208
  • Abstract
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 In recent years lesions on the anterior wall of the stomach in otherwise healthy persons are being more accurately diagnosed, but in patients in postapoplecatal stage these lesions are often difficult to examine because of hemiplegia or other bodily conditions. The case here described seems to corroborate the necessity of careful examination of the stomach in such physically hampered patients.

 Case : a 64-year-old man. Two weeks after he had been attacked with apoplexia in September 1969, he began to suffer from increasing gastric distress. One year later, he was examined by x-ray because of full sensation of the stomach, and was diagnosed as gastric ulcer on the posterior wall of the corpus associated with another small excavated lesion on the anterior wall at the level of the angle. Although ulcer on the posterior wall of the corpus was gone after three months' hospitalization, the other lesion of the anterior wall of the angle remained unchanged. For yet another five months he was treated as intractable ulcer, but the lesion persisted. Accordingly he was referred to our hospital in April 1971.

 Present status : left hemiplegia and scoliosis. The abdomen was of normal consistency and no tumor was palpated. Laboratory reports were all within normal limits.

 X-ray examination : Because of his stooped posture, it was hard delineate his stomach, but in a double contrast picture of the anterior wall in prone position was seen a localized, shallow barium fleck on the anterior wall of the angle with rugal convergence toward it. These ceased folds were clubby at the tips.

 Endoscopic findings : A small, oval, and slightly irregularly excavated lesion was noted on the antorior wall of the angulus region. It was covered with white coat, and the surrounding mucosa was strongly reddened. Some converging folds were irregularly interrupted at the reddened margins. Of nine mucosal fragments obtained by biopsy under direct vision, two proved to be malignant.

 Subtotal gastrectomy was performed (S0 N0 H0 P0).

 Findings of the resected stomach : An irregularly shaped shallow depression, measuring 6×8 mm, was seen in the center of the anterior wall of the angulus region. A very small ulcer was observed in the center. The whole lesion even including the marginal reddened areas was less than 10 mm in diameter. It was judged as very minute early gastric cancer of type Ⅱc+Ⅲ. Histologically, it proved to be adenocarcinoma tubulare localized within the mucosal layer.


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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