胃・十二指腸同時性早期重複癌の1例 A CASE OF EARLY SYNCHRONOUS DOUBLE CANCER OF STOMACH AND DUODENUM

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胃・十二指腸同時性早期重複癌を報告する.症例は64歳の男性,悪心を主訴に受診し精査にて胃幽門部にIIa+IIc型早期胃癌,十二指腸球部にBorrmann 2型様十二指腸癌の診断を得て膵頭十二指腸切除術を施行した.組織学的には胃病変は高分化型腺癌,深達度mで,十二指腸病変は乳頭腺癌,深達度smでリンパ節転移を認めなかった.本邦では胃・十二指腸同時性重複癌は27例が報告されており,平均年齢64歳で,男性17例,女性10例であった.胃癌の特徴としては幽門部, IIc, 高分化型腺癌,十二指腸癌では球部, Borrmann 2型様,高分化型腺癌が多かった.術式は膵頭十二指腸切除および球部切除を含んだ胃切除が多く用いられていた.胃癌と比較し,十二指腸癌は隆起性病変が多く,早期癌ではリンパ節転移の頻度が非常に少ない.したがってこの点を考慮にいれた全身状態に応じた術式を選択することが重要であると考えられた.

We report a case of early synchronous double cancer of the stomach and duodenum. A 64-year-old man was admitted to the hospital because of nausea. Under a diagnosis of IIa+IIc type early gastric cancer of the antrum and Borrmann 2 type like duodenal cancer of the bulbus, pancreatoduodenectomy was carried. Histopathological findings were that the gastric lesion was well differentiated adenocarcinoma limited in mucosa and the duodenal lesion was papillary adenocarcinoma invasive to submucosa with no lymph node metastasis. Synchronous double cancer of the stomach and duodenum was rare, and 27 cases have been reported in Japan. The patients were 17 males and 10 females with an average age of 64 years old. Characteristic findings of these gastric cancers included location in the antrum, classification of IIc and histology of well differentiated adenocarcinoma. Characteristic findings of these duodenal cancers included location in the bulbus, Borrmann 2 type and well differentiated adenocarcinoma. Pancreatoduodenectomy and gastrectomy with partial duodenectomy were frequently performed. Compared with gastric cancers, duodenal cancers predominantly appeared as protruding type and had a low incidence of lymph node metastasis in early stage. So it is important to select an approciate surgical procedure according to the systemic condition of each patient entertaining the above mentioned characteristics.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 57(12), 3019-3024, 1996-12-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008525640
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    03869776
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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