A CASE OF EARLY GASTRIC CANCER ARISING FROM A HYPERPLASTIC POLYP WITHIN AN UPSIDE-DOWN STOMACH

Abstract

The patient is an 81-year-old female. Several months previously, she was examined due to continuing pains in the front of the chest. Three years prior to this, 10mm large hyperplastic polyps were observed at two locations in her stomach, but they were not recognized to have malignant potential. After careful examination this time, the same lesions were found to have increased to 30mm in size, and biopsy examination revealed adenocarcinoma. In the CT scan of the patient’s chest, it was found that she had an upside-down stomach, since the entire stomach had deviated from inside the mediastinum. Based on the diagnosis of early gastric cancer accompanied by an upside-down stomach, we decided to perform open surgery. The hernial orifice was opened to a size of 8cm, through which the stomach was pulled, and the hernial orifice was then plicated. Distal gastrectomy with D1 lymphadenectomy was then performed. This case exhibited not only the rare and unique condition of an upside-down stomach but also the rare phenomenon of hyperplastic polyps becoming cancerous. This rare case is presented along with a review of the relevant literature.