2年間の経過を観察しえたスキルスの1例

Scirrhous Carcinoma of the Stomach Followed Up for Two Years

　スキルスでその経過を十分に観察することのできた症例は大変少ない．これは1つにはこの病変の時間経過がきわめて速いこと，更に一般には癌と診断された時点で手術が行われるのが通常で，その後どういう変化で経過するかをつかみにくいことにもよろう．本症例は重症の糖尿病と高度の腎機能不全によって手術ができず，経過観察中にスキルスとなり，死亡した貴重な症例である．

　The first examinations with upper GI-series and gastroscopy of a man aged 63 showed Ⅱc type of early gastric cancer, and adenocarcinoma was proved in biopsy specimens obtained from this lesion. However, a radical operation was impossible, since the patient had suffered from diabetes mellitus with severe diabetic nephropathy. Three months after the first examination, this lesion developed into Ⅱc+Ⅲ type of early cancer. One year and 2 months later, the advanced gastric cancer (Borrmann 2 type) was observed in the same place. Three months later, this advanced cancer developed into the scirrhous type of carcinoma and this patient died 2 years after the first examination.

　This case taught us that a scirrhous type of gastric cancer might develop from Ⅱc type of early cancer or from Borrmann 2 type of advanced cancer.