胃・十二指腸同時性早期重複癌の1例

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  • A CASE OF EARLY SYNCHRONOUS DOUBLE CANCER OF STOMACH AND DUODENUM

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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.

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