早期胃癌（Ⅱb＋Ⅱc）に多発性結腸癌を伴った1症例

A Case of Early Stomach Cancer (IIb＋IIc) Associated with Colon Cancers of the Ascending and Transverse

　わが国での平均寿命の延長，悪性腫瘍に対する診断技術の進歩などによって，近年重複癌の頻度が増加しつつある．

　われわれは，最近，早期胃癌に上行結腸と横行結腸の多発性結腸癌を伴った症例を経験したので，ここにその概要を報告する．

　Many cases of multiple primary cancer have been increasingly reported recently because of prolonged life expectancy and progress in diagnosis and treatment of cancer.

　Recently we have encountered a rare case of primary synchronous multiple cancer, the one an early cancer of the stomach and the others cancers of the ascending and transverse colon.

　A 60-year-old housewife was admitted to our clinic on May 24, 1972. She had been suffering from epigastric pain of three months' duration.

　Stomach cancer had been suspected by her referring doctor through fluoroscopy.

　Physical examination revealed two tumors in RLQ and umbilical region that were hard and movable. Cervical and Virchow's lymphnodes were not palpable.

　Examinations of the stomach by fluoroscopy with contrast media and by GTF showed early stomach cancer (IIc type). Barium ename revealed two shadow defects in the ascending and transverse colon; Biopsies of the stomach and transverse colon disclosed histologically carcinoma simplex (signet-ring cell type) and adenocarcinoma respectively.

　Histologic diagnoses of the surgical specimens were almost the same as the preoperative diagnoses: The lesion in the stomach was early cancer (IIb＋IIc type) and colonic lesions were Dukes B. There was a distance of 13.5 cm between two colonic lesions. Regional lymphnodes of three lesions were all free from metastasis.

　Definition and frequency of multiple primary tumors are discussed based on the literature.