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A Recurrent Case of Multiple Early Gastric Cancer Motonosuke Furusawa 1 1The Second Dept. of Surgery, Faculty of Medicine, Kyushu University pp.579-586
Published Date 1970/5/25
DOI https://doi.org/10.11477/mf.1403111278
  • Abstract
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 Information has been obtained of all but one of 106 cases of early gastric cancer operated on in the authors' department. Of these, recurrence has been confirmed in 10. This paper deals with one of such cases, which was multiple early gastric cancer already at the time of the first operation.

 The patient, a 34-year-old male, underwent gastrectomy (R2) in Feb., 1967. In the resected specimen there were on the anterior wall of the corpus a Ⅱc type mucosal cancer (less differentiated tubular adenocarcinoma), measuring 3.0 by 1.7 cm, and on the greater curvature of the body a I type mucosal cancer (papillary adenocarcinoma), measuring 3.0 by 3.0 cm. This was confirmed as multiple early gastric cancer with normal gastric wall in between. The distances from these lesions to the oral stump measured 2.5 and 6cm, respectively (OW). Resected lymph nodes were free from cancer. The postoperative course was favorable. Then at an x-ray examination done 1 year and 11 months after the operation, recurrence of cancer was recognized on the lesser curvature of the remnant stomach, so that the patient underwent re-operation in May, 1969 (2 years and 3 months after the initial surgery). Cancer existed in an area surrounding the lesser curvature of the gastric remnant, being less differentiated tubular adenocarcinoma invading the subserosal layer. No metastasis was found in the lymph nodes excised for cleaning. He has been having favorable progress toward recovery. As of the third year after the first operation, he is enjoying good health.

 The facts that this case was of multiple cancer from the outset, and that neither lymphatic nor vascular invasion was recognized within the two lesions led the authors to overlook the possible existence of another cancer lesion in the gastric remnant, probably because it was too slight to attract attention. The lesion found at the second operation was considered to have developed from this minute one.

 As incidence of multiple early gastric cancer is not too infrequent, it is especially stressed that strict care must paid not to miss any lesion in the cardia, fornix and oral part of the corpus so as not to overlook any possible cancer lesion in the remnant stomach. A few comments have been made on recurrent cases of early gastric cancer encountered in the authors' department.


Copyright © 1970, 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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