Ⅱa型早期胃癌が1型にかなり急速に生育したと思われる1例

A CASE OF Ⅱa TYPE EARLY GASTRIC CANCER DEVELOPING INTO TYPE I IN A FAIRLY SHORT TIME

はじめに

　最近retrospectiveな検討が可能となり早期胃癌や率の初期像を探すことができるようになってきている．筆者らもⅡa型早期胃癌が1型に生育したと思われる興味ある1例を経験したのでここに報告することとした．

　Case: a 68-year-old female farmer.

　Past history: At 20 suffered from acute hepatitis; at 38 hysterotectomy after a still birth. In May 1967 an abnormality was suspected in her stomach at a gastric mass survey in Gumma Prefecture. The first gastrocamera examination in the same month led to the diagnosis of gastric polyp. The second done in Aug. of the same year established it as Ⅱa or I type early gastric cancer, which was confirmed by biopsy as well. At the time of her admission in Sept. 1967 to the First Division of Internal Medicine, Gumma University, general laboratory examinations revealed nothing noteworthy. X-ray findings of the stomach: The base of polypoid shadovv, visualized by double contrast study in the greater curvature side of the antrum, was of irregular depression, and it could be diagnosed as cancer. The polypoid lesion, diagnosed as such by the initial gastrocamera examination, was, when retrospectively studied, already cancer then as it has characteristics of Ⅱa. In pictures taken 3 months later, the protrusion was noticeably larger. The constriction of the tumor was more conspicuous, and it seemed to have grown larger with its original shape being maintained as it was both in height and breadth. Pathologically it was papillotubular adenocarcinoma, measuring 14×13×11 mm. As it was accompanied with inflammatory changes, it could not be definitely established that the tumor had grown larger by cancerous proliferation. However, it is of interest that the growth of a tumor was clearly recognized within a relatively short time of 3 months. Other cases similar to this may possibly be detected by follow-up of gastric polyps.