8年6カ月間経過を追求した早期胃癌

A CASE OF EARLY GASTRIC CANCER RETROSPECTIVELY INVESTIGATED FOR 8 YEARS AND 6 MONTHS

はじめに

　8年6カ月の長期にわたり経過を追求したⅡc＋Ⅲ型早期胃癌の1例を報告する．この型の早期胃癌の進展速度や，いわゆる悪性サイクルを考える上で興味あると考えられる症例である．

　This is a case of early gastric cancer which has been retrospectively studied roentgenologically as well as endoscopically all through 8 years and 6 months prior to the surgical intervention.

　The first x-ray films taken in June 1959, when the patient visited the authors' department on accout of hunger pain in the epigastrium, provide, when retropectively studied now, ample evidence, such as irregular-shaped ulcer and abrupt cessation of the mucosal folds, to suspect cancer. However, in the gastrocamera pictures taken in the following months, the ulcer has diminished in size; it has cicatrizecl completely in Oct. of the same year. In May 1961 an ulcer of irregular shape, suggesting of another acute aggravation, again appears associated with a depression as of Ⅱc in the surrounding areas. In the following month it again shows marked reduction in size. Except for minor changes, the lesion remains in a cicatrized state until the end of 1965, and the site suggesting of Ⅱc shows only engorgement with no depression to be seen. Then in 1966 the ulcer again becomes active, now enlarging and now reducing repeatedly in a short space of time. The operation was performed in Dec. 1967, indeed 8 years and 6 months after the initial examination.

　The resected specimen showed Ⅱc+Ⅲ type early gastric cancer with an ulcer as its center, measuring 48 by 52mm. The degree of depth invasion was “m”. Histologically it was adenocarcinoma mucocellulare, Broders 4.

　In spite of a very long duration of its course, it has remained all through in the state of intramucosal cancer. The shortest period of its “malignant cycle” was 10 months and the longest,3 years and and 7 months.