幽門側胃切除術後3年8か月の経過で原病死した早期胃癌（胎児消化管類似癌）の1例

A Patient with Early Gastric Cancer（Adenocarcinoma with Enteroblastic Differentiation）Who Died 3 Years and 8 Months Following Pyloric Gastrectomy, Report of a Case

要旨●患者は70歳代，女性．胃前庭部前壁に大きさ45mmの0-IIa＋IIc型早期胃癌を認め，内視鏡的粘膜下層剝離術を施行したが，病理組織学的診断で，pT1b2（SM 2,075μm），中分化管状腺癌＋胎児消化管類似癌，medullary，INFb，Ly1，V1，pHM0（4mm），pVM1であったため，2か月後に幽門側胃切除術を施行した．手術標本の病理組織学的診断では遺残を認めず，また遠隔転移も認めなかったが，3年8か月後に腹膜播種を来し死亡した，予後不良であった早期胃癌（胎児消化管類似癌）症例を経験したので報告する．

　The patient was a woman in her 70s. Endoscopic submucosal dissection was performed for an early gastric cancerous tumor 45mm in size on the anterior wall of the stomach. Histopathological diagnosis displayed pT1b2（SM, 2,075μm）, moderately differentiated tubular adenocarcinoma＋adenocarcinoma with enteroblastic differentiation, medullary, INFb, ly1, v1, LM（−）4mm, and VM（＋）. The patient underwent pyloric gastrectomy and died of peritoneal dissemination 3 years and 8 months later. Herein, we reported a case of early gastric cancer（adenocarcinoma with enteroblastic differentiation）with a poor prognosis.