A Case of Gastric Cancer that Occurred Ten Years after Diagnosis of Primary Biliary Cirrhosis

Takehiro Sakai, Koichi Sato, Masanori Tanaka¹⁾, Koji Suto²⁾, Akihito Kon, Yasuhiro Sudo and Yoshie Hasegawa

Department of Surgery, Department of Pathology and Laboratory Medicine¹⁾ and Department of Internal Medicine²⁾, Hirosaki City Hospital

A 74-year-old woman, treated with ulsodeoxycholic acid for 10 based on a diagnosis of primary biliary cirrhosis (PBC) and referred for bloody stool was diagnosed as having a bleeding gastric ulcer and pyloric stenosis due to advanced gastric cancer, necessitating distal gastrectomy with D2 lymph node dissection and liver biopsy. Macroscopically, a type 1 tumor was located from the pyloric antrum to the duodenum, and was found histopathologically to be poorly differentiated adenocarcinoma invading to the muscular layer. The final stage of gastric cancer was IB. An Ul-II ulcer was also seen in the anterior wall of the gastric body, and Helicobacter pylori was detected from the background mucosa. Histologically, the liver biopsy indicated stage 3 based on Scheuer's classification. The postoperative course was uneventful except for transient liver dysfunction. The patient was discharged on postoperative day (POD) 31. Patients with PBC sometimes have extrahepatic malignancies, and reports of gastric cancer coexisting with PBC are relatively rare. Gastric cancer occurring more than a decade after PBC diagnosis is very rare. Patients with PBC should thus be examined carefully for extrahepatic malignancies, including the gastrointestinal tract during follow-up.

Key words
primary biliary cirrhosis, gastric cancer, Helicobacter pylori

Reprint requests
Takehiro Sakai Department of Surgery, Hirosaki City Hospital
3-8-1 O-machi, Hirosaki, 036-8004 JAPAN

Accepted
March 28, 2007

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