A Case Report of Multiple Gastric Carcinomas of Seven Lesions Following Completely Cured Metachronous Double Carcinomas on Sgimoid and Ascending Colon

Naoto Kurihara, Hisashi Shinohara, Hajime Yonekawa, Takao Machimura, Toshiharu Furukawa, Hideki Nishibori, Hideki Tatematsu, Hidejirou Uragami, Yuji Nemoto, Miwako Mukai¹⁾

Department of Surgery, National Okura Hospital
¹⁾Department of Pathology, National Okura Hospital

A 42-year-old woman who had a sigmoidectomy for sigmoid colon carcinoma in 1983 and right hemicolectomy for ascending colon carcinoma in 1989 was admitted with a chief complaint of epigastric discomfort in 1995. She was diagnosed by endoscopy as having two advanced gastric carcinomas. Total gastrectomy with splenectomy and Roux-en Y reconstruction was performed on September 28, 1995. Two lesions of type 3 advanced gastric carcinoma on the anterior and posterior walls of the body, and five lesions of type 0-IIa early gastric carcinoma on the antrum and body were observed independently. The two lesions of type 3 advanced gastric carcinoma were histologically diagnosed as moderately differentiated adenocarcinoma invading the subserosal layer. Three of the five lesions of type 0-IIa early gastric carcinoma were diagnosed as well-differentiated adenocarcinoma invading the mucosal layer and the other two were diagnosed as well-differentiated adenocarcinoma invading submucosal layer, respectively. These lesions of gastric carcinoma were stained positively by immunohistochemical staining for p53 and Ki-67, and were negative for c-erb B-2 and, bcl-2. Chronic gastritis with intestinal metaplasia was observed, which was positive for Helicobacter pylori infection. It is important that we establish a high risk group by finding out factors, which may predict future occurrence of multiple cancers.

Key words
multiple gastric carcinomas, metachronous cancers, high risk factor

Reprint requests
Naoto Kurihara Department of Surgery, National Okura Hospital
2-10-1 Okura, Setagaya-ku, Tokyo, 157 JAPAN

Accepted
September 9, 1997

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