A 50-year-old woman visited the Aichi Cancer Center Hospital with epigastric pain of three year's duration. Physical and laboratory examinations revealed no abnormalities except for positive occult blood in the stools. An upper GI series and gastroscopy revealed multiple polypoid lesions from the antrum to the middle body and a healing ulcer with smooth converging folds on the posterior wall of the middle body of the stomach. The diagnosis was consistent with gastric polyposis and a benign healing ulcer. Biopsy revealed adenocarcinoma from both polypoid lesions and the intervening mucosa. Total gastrectomy was performed. The mucasal aspect of the resected stomach showed a fairly sharply demarcated, dark red discolord and extensive lesion occupying a large area from the antrum to the upperr body, and consisting of shallow depressions inter-mingled with small round elevations, and a healing ulcer with converging folds on the posterior wall of the midbody. Multiple sections of the entire lesion reveald it to be of a tubular adenocarcinoma of superficial spreading type, involving only its mucosal layer, even sparing its deepest portion. The carcinoma was largely of moderate differentiation. The area of the healing ulcer was largely covered by a non-neoplastic regenerative epithelium.
