3年3ヵ月間X線で経過が観察された早期胃癌の1例

A CASE OF EARLY GASTRIC CANCER FOLLOWED UP FOR 3 YEARS AND 3 MONTHS

Ⅰ．はじめに

　X線ならびに内視鏡検査における記録性の向上を胃癌の進展ないし経過に関しても種々の知見をもたらしつつある．すなわち胃癌の少なくも一部のものにおいては，あるいはまた少なくもある時期においてはその進展が相当に緩徐であることはもはや周知の事実といえよう．さらにまた悪性潰瘍においてもニッシェの縮少，消失，増大の反覆がおこりうることは，いわゆる悪性life cycleとして諸家の報告にみるごとくである．以下X線像により病変の推移を観察しえたかかる1症例について報告する．

　Case: a 62-year-old woman. Since Jan. 1958 she had been treated as gastric ulcer because of epigastric pain. As her illness, however, got none the better, she came to the authors' hospital. At the x-ray initial examination of the stomach, a deep depressed lesion the size of a forefinger-tip was visualized on the posterior wall at the incisura, encircled by a shallower depression of relatively wider extent. During the period of 3 years and 3 months since then, this deep depression came and went at least twice in x-ray pictures, and another lesion suggesting of more shallow depression as well as cessation of the mucosal folds in its neighborhood came and went several times as well. The gastric juice was of normal acidity. In Apr. 1966 gastrectomy was performed. The posterior wall of the stomach had fibrinous adhesion with the pancreas. In the resected stomach was found an ulcer on the lesser curvature near the posterior wall at the level of the angle, encircled by another shallower depression of irregular contour. Histologically, these two depressions proved to be ulcer carcinoma of Hauser type (in a broader sense) of class Ul-IV. Cancer cells were mostly localized within the mucosal layer; some were found to have penetrated into the submucosal layer.

　A report has been made in this paper of a case of Ⅱc+Ⅲ type early gastric cancer, confirmed by operation as such and which had a previous history of ulcer of as long as 6 years and 4 months' duration. Its latter half, about 3 years and 3 months, showed typical malignant life circle. As of the time 3 years and 5 month after the operation the patient is enjoying good health.