A CANCER IN PAPILLARY ADENOMA (GASTRIC EPITHELIAL TYPE) OF THE STOMACH PROLAPSING INTO THE DUODENAL BULB-REPORT OF A CASE

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  • KUNIHARA Takashi
    Department of Surgery, Oji General Hospital Second Department of Surgery, Hokkaido University
  • TAKAHASHI Toru
    Department of Surgery, Oji General Hospital
  • MITO Yasufumi
    Department of Surgery, Oji General Hospital
  • HIRAGUCHI Etsuo
    Department of Surgery, Oji General Hospital Second Department of Surgery, Hokkaido University
  • SHIMADA Toshifumi
    Department of Surgery, Oji General Hospital Second Department of Surgery, Hokkaido University
  • KATO Hiroyuki
    Second Department of Surgery, Hokkaido University

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  • 十二指腸へ脱出した胃上皮型cancer in adenomaの1例

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Abstract

Recently we experienced a case of cancer in adenoma of the stomach (gastric epithelial type) prolapsing into the duodenum.<br> A 63-year-old woman was admitted to the hospital because of upper abdominal discomfort. Gastric endoscopy revealed an elevated lesion of Yamada type III with the diameter of about 4 cm prolapsing into the duodenum from pylorus ring. Polypectomy with an incision of the pylorus of the stomach was carried out. Intraoperative frozen section diagnosis resulted in adenoma. Postoperative examination, however, indicated papillary adenocarcinoma in adenoma with a possible remnant malignancy in the polypectomy stump. Distal gastrectomy was added.<br> Gastric epithelial type of papillary adenoma which has been reported to represent less than 3% of all gastric adenomas prones to cancer change in a high frequency. This adenoma should be treated accordingto cancers. Reports on an elevated lesion prolapsing into the duodenum are so rare and only 100 cases have been seen in the Japanese literature in a recent 4 decades.

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