Early Gastric Cancer with Dieulafoy's Ulcer and Diffuse Bone Metastasis, Diagnosed after Resection of Bilateral Ovarian Tumors: A Case Report

Takumi Shimomatsuya, Kazuhiro Maruhashi, Hisashi Sasaki, Yuto Oh, Naoko Kamo, Keibun Hara and Tsukasa Shimogo^*

Surgical Department, Nagahama Red Cross Hospital, Sakata Clinic^*

We report a case of early gastric cancer with diffuse bone metastasis, which was diagnosed after resection of bilateral ovarian tumors. A 42-year-old woman underwent bilateral oophorectomy. Histological examination revealed signet-ring cell carcinoma. Endoscopy disclosed a IIc lesion on the upper body of the stomach. Bone scintigram showed diffuse metastasis. Just after systemic chemotherapy (MTX-5FU) was started, gastric hemorrhage was found. Emergent endoscopy detected bleeding similar to Dieulafoy's type ulcer. Although the bleeding was stopped by endoscopic clipping, rebleeding occurred and emergency surgery was performed. Histological findings of the resected stomach revealed early gastric cancer (sm1) without lymph node metastasis. Needle bone biopsy also revealed signet-ring cell carcinoma. Also, the platelet count was decreasing and ALP was increasing gradually. As DIC was diagnosed, systemic chemotherapy was restarted and FOY was administered. Two months later, the patient died of subdural hematoma.

Key words
early gastric cancer, Dieulafoy's ulcer, ovarian metastasis

Reprint requests
Takumi Shimomatsuya Surgical Department, Nagahama Red Cross Hospital 14-7 Miyamae-cho, Nagahama City, 526-8585 JAPAN

Accepted
September 20, 2000

To read the PDF file you will need Abobe Reader installed on your computer.