Occurency of Extremely High Level of Elastase-1 in a Patient of Giant Gastric Cyst

Tetsuya Kaneko, Yasuro Kurisu, Satoru Tohji, Toshiya Wamata, Hiroshi Hiraoka, Yousuke Miyano, Takenori Iwai, Hisashi Tani, Kazuo Kurayoshi*

Department of Surgery, Youka Municipal Hospital
*First Department of Surgery, Tottori University School of Medicine

Although microscopic gastric cystic lesions are common in resected specimens, few cases are a problem surgically. We experienced a case of a giant gastric cyst in the cardia, with extremely high levels of elastase-1 in the serum and in the fluid aspirated from the cyst, in which the differential diagnosis from pancreatic cyst was difficult. An 82-year-old male, who admitted for treatment of inguinal hernia and in whom abdominal ultrasonography revealed a cystic tumor in the stomach, was readmitted because of gradual enlargement of the tumor. An upper GI series revealed a submucosal tumor in the stomach. Ultrasonography and CT scan revealed a gastric cyst, and laparotomy was performed because of the possibility of pancreatic cyst. Total gastrectomy was performed for gastric cyst, and the resected specimen was 90×80 mm in diameter, 64 mm in height. Histologically, it was a giant gastric pseudocyst, in which heterotopic and lymphatic cysts were observed in the gastric submucosa. Although clinically malignant gastric cyst has a very low frequency, special attention should be paid to diagnosis and therapy in patients with a cyst in the stomach.

Key words
elastase-1, gastric cyst

Reprint requests
Tetsuya Kaneko First Department of Surgery, Tottori University School of Medicine
36-1 Nishimachi, Yonago, 683 JAPAN

Accepted
December 10, 1991

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