SYNCHRONOUS GASTRIC CARCINOMA IN 22 LESIONS WITH VARIOUS HISTOLOGICAL TYPES-REPORT OF A CASE-

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  • 多彩な組織型を呈した同時性２２多発胃癌の１例

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Abstract

A 68-year-old man with a 4-day history of epigastralgia was admitted to the hospital because of intra-abdominal free air on a chest X-ray film. Upper GI endoscopic study following 7-day conservative management for gastric perforation revealed multiple (six) depressed lesions of the stomach. Biopsy proved group V cells in all the six lesions. Total gastrectomy with Roux-en-Y reconstruction and D2 lymph node dissection was performed. Postoperative pathological evaluation disclosed 22 lesions, including one IIc like advanced carcinoma, five 0-IIc type early carcinomas, and sixteen 0-IIb type early carcinomas. Of these 22 lesions five were well-differentiated tubular adenocarcinoma, 11 were moderately differentiated tubular adenocarcinoma, one was non-solid poorly differentiated adenocarcinoma, and the other five were signet-ring cell carcinama.<br>Recently, synchronous multiple gastric carcinomas have been increasingly reported. However, most of them occur in two or three lesions. The synchronous gastric carcinoma in 22 lesions showing various histologies as in this case seems to be extremely rare.

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