J.Jpn. Surg. Soc.. 88(8): 1024-1030, 1987

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Case report

EARLY GASTRIC CANCER ASSOCIATED WITH ECTOPIC GASTRIC MUCOSA (SUBMUCOSAL CYSTS)

A 72 year-old man visited our hospital complaining of anorexia and hungry epigastric pain. Gastrofiberscopy and upper G-I series examination established the diagnosis of double gastric cancers. Total gastrectomy, R₂ lymphadenectomy and β anastomosis were performed. The type IIc early cancer lesion at the pyloric vestibule was sm in depth and revealed a histological pattern of tubular adenocarcinoma. The multiple lesions on the anterior and posterior walls of the lesser curvature were a cluster of submucosal cysts, and were partially accompanied by signet-ring cell carcinoma having the depth m. The two lesions were histologically isolated without continuity, and the histology progress was P₀ H_0n r; (-) ps (-), Stage I, aw (-), ow (-). Postoperative course was uneventful.
Though multiple diffuse ectopic gastric mucosa is seemed to be benign submucosal tumor of the stomach, occasional co-existence of cancer has been frequently reported. Even if the results of gastrofiberscopy and upper G-I series results are negative, there is always a possible risk of overlooking a small cancerous focus. On detecting ectopic gastric mucosa, immediate and thorough resection seems desirable, especially when accompanied by cancer.
The pathogenesis of multiple diffuse ectopic gastric mucosa has remained controversial and has been explained by the theory of either congenital or acquired aberration. From the histological findings, the pathogenesis of this case could not be determined.

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