症例6 23歳（♀）の早期胃癌

A Case of Earlg Gastric Cancer in a 23-Year-Old Female

　この症例は，自覚症なく若年であるにもかかわらず，職場の胃集団検診があった際，たまたま受診したために発見された症例である．

　患　者：平○澄○　23歳　♀　公務員

　昭和44年10月胃集検を受診，要精検の診断をうけ，12月当院受診し，翌45年2月12日入院させ精査の結果，早期胃癌と診断し，3月3日国立栃木病院外科に転院させ3月11日手術した．

　A young woman, completely free from subjective symptoms pertaining to the stomach, was nevertheless found at an occupational gastric mass screening to harbor early cancer of the stomach.

　The patient : S. H., 23-year-old female, public service personel. In October 1969 she underwent gastric rnass survey and had been found to have a gastric lesion thoroughly to be examined. In December of the same year she visited our hospital, and after admission on February 12, 1970, she was examined in detail. The diagnosis : early gastric cancer. On March 3, she was transferred to the Surgical Department of Tochigi National Hospital, and on 11 inst. she was operated on.

　X-ray findings before operation: A niche of irregular shape was seen on the posterior wall above the angle near the lesser curvature side with surrounding abrupt cessation of mucosal folds and partial swelling of their distal tips.

　Endoscopy findings : An ulcer was seen above the angle, encircled by distinct elevations with partial bleeding spots. An well noticiable mucosal fold ran toward the lesion from the oral side, swollen at the tip and ceasing irregularly.

　Gross findings of the resected specimen : The lesion was located on the lesser curvature a little over to the posterior wall. It was an open ulcer, measuring 1.2×0.7 cm. Mucosal f olds converging towad it were thinner on the ulcer side, especially becoming slender on the oral side.

　Histopathological findings : The ulcer was an open one, Ul-Ⅱ, entirely surrounded by tubular adenocarcinoma, com-posed of tubular formation with partial appearance of signet ring cells. As the patient commited suicide one year later, it was impossible to follow her up for a longer time.