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Stomach and Intestine(Tokyo) Volume 18, Issue 7 （July 1983）

胃と腸 18巻7号（1983年7月発行）

Japanese English

症例

53ヵ所に多発病巣を認めた胃癌の1例 Multifocal Gastric Carcinoma Which Had 53 Foci, Report of a Case 江間幸雄 ¹ , 林繁和 ¹ , 鈴木正之 ¹ , 佐竹立成 ² , 芳野純治 ³ , 中澤三郎 ³ Y. Ema ¹ , S. Hayashi ¹ , M. Suzuki ¹ , T. Satake ² , J. Yoshino ³ , S. Nakazawa ³ ¹名古屋掖済会病院消化器科 ²名古屋掖済会病院病理 ³名古屋大学医学部第2内科 ¹Department of Gastroenterology, Nagoya Ekisaikai Hospital ²Department of Pathology, Nagoya Ekisaikai Hospital ³The Second Department of Internal Medicine, Nagoya University, School of Medicine pp.747-752

発行日 1983年7月25日 Published Date 1983/7/25

DOI https://doi.org/10.11477/mf.1403109482

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Abstract 文献概要
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サイト内被引用 Cited by

　今回，われわれは胃内に50ヵ所以上の癌の多発を認め，しかもその過半数が長径5mm以下の微小癌であった胃癌の1症例を経験したので，文献的考察を加え報告する．

症例

　患　者：45歳，男性．

　主　訴：嘔気，項部痛．

　既往歴：特記すべきものなし．

　家族歴：父親，脳卒中．

　現病歴：1980年1月初めより，空腹時に嘔気を覚え近医受診，胃潰瘍と言われ投薬を受けていた．一方，10月末ごろより時々首筋の疼痛があったが，11月22日ごろより痛みが激しくなり，11月29日入院した．

　We experienced a case of multifocal gastric carcinoma which had 53 foci and the most of them were minute gastric cancers.

　The patient was 45 year-old man who was admitted with nausea and nuchal pain. U.G.I. series and endoscopic examination disclosed multiple differentsized depressed lesions with irregular margin at the angulus and the antrum. A depressed lesion without converging folds, clubbing and fusion of the folds was also noted at the posterior aspect of the lower gastric body, and furthermore, multiple minute depressed lesions were scattered all over the stomach. Total gastrectomy was performed with a diagnosis of multiple gastric carcinoma.

　Precise evaluation of the resected specimen disclosed that the foci of the gastric carcinoma were 53 and more than half of them (36 lesions) were minute gastric carcinomas of which long axis was less than 5 mm. Depth of their invasion was as follows: pm lesion was seen in one, sm was in two and the rest of them were early gastric cancers. Larger lesions were mainly found in the antrum and the angulus, and the minute lesions were mainly in the mid and upper portion of the gastric body. Regarding histological type, the majority of them were signet-ring cell carcinomas and in part, adenocarcinoma with ductal formation was noted elsewhere in the lymph ducts and vessels in the antrum and the angulus, but it was rarely noted at the lower and upper portion of the gastric body. Continuity of the each lesions was not demonstrated, therefore it was diagnosed as multifocal gastric carcinoma.

　Many cases of multifocal gastric carcinoma have been reported but the majority of them had 2～4 foci, and 25 foci which was reported by Yarita et al was extremely rare. Our case had 53 foci and it raises various interesting questions on development and growth of the cancer.