早期胃癌と早期十二指腸癌を合併した1例

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  • A CASE OF EARLY GASTRIC CANCER ASSOCIATED WITH EARLY DUODENAL CANCER

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A 65-year-old man was admitted to the hospital because of epigastric discomfort. X-ray examination revealed an elevated lesion in the body of the stomach and a polypoid lesion in the duodenal bulb. Endoscopic examination showed a 18×16mm IIa+IIc gastric tumor. The polypoid lesion of the duodenal bulb could not be detected by endoscopy. The biopsy specimen from the gastric lesion showed histological evidence of malignancy.<br> Distal gastrectomy was performed including the duodenal polyp adjacent to the pylorus. Histological examination showed that the lesion of the stomach was moderately differentiated tubular adenocarcinoma that invaded the submucosal layer without lymph node metastasis and that the duodenal polyp was 10×10×10mm well-differentiated adenocarcinoma limited to the mucosal layer. The patient is well two years after the operation, without any evidence of recurrence. The family and past histories of this patient meet the criteria of hereditary nonpolyposis colorectal cancer. Our survey of the literature suggested that this is the 8th reported case of early carcinoma of the stomach associated with early duodenal carcinoma in Japan.

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