A Case of Giant Protein-Losing Gastric Cancer Treated by Partial Resection of the Stomach

Masaya Nomura, Yoshifumi Inoue, Shigeo Fujita, Jun Sakao, Masaki Hirota, Shigeo Souda and Masato Ohshima*

Department of Surgery, Nissay Hospital, Nippon Life Saiseikai Foundation
Department of Pathology, Nissay Hospital, Nippon Life Saiseikai Foundation*

An 87-year-old man admitted for lower extremity edema was found to have severe hypoproteinemia (serum total protein: 3.2 g/dl, serum albumin: 1.7 g/dl) and a giant elevated cauliflower lesion in the stomach. Gastric juice included very high protein (1,180 mg/dl), and a ^99mTc-HSA protein-losing test showed the leakage of HSA into the gastric lumen. The patient was diagnosed with protein-losing gastric cancer. Administration of albumin before surgery did not prevent hypoproteinemia. Partial resection reduced the edema and hypoproteinemia. The tumor was diagnosed as early gastric cancer (papillary adenocarcinoma, sm). Surgery resulted in curability B, and no recurrence was found during 11 months of postoperative follow-up. Protein-losing gastric cancer is relatively rare, and only about 40 cases have been reported in the Japanese literature, most of which were treated with distal gastrectomy or total gastrectomy. Our case is the first undergoing partial resection of the stomach. Because patients with this disease often suffer preoperative malnutrition and early stage despite its tumor size, surgery should be minimized.

Key words
gastric cancer, protein-losing gastroenteropathy, hypoalbuminemia

Reprint requests
Masaya Nomura Department of Surgery, Nissay Hospital, Nippon Life Saiseikai Foundation
6-3-8 Itachibori, Nishi-ku, Osaka, 550-0012 JAPAN

Accepted
October 19, 2004

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