A CASE OF VILLOUS ADENOMA COEXISTING WITH IIb+IIc TYPE EARLY CARCINOMA OF THE STOMACH

Abstract

A 68 years old female was admitted to the hospital complaining of an abnormal sen-sation in her abdomen for 6 months. But during this time, she had no loss of appetite, change of bowel habits and no weightloss. Laboratory studies revealed a hemoglobin of 13.6gm/dl, hematocrit 41.5%, red blood cell count 453 million with normal differential. Stool specimens revealed evidence of blood. Upper gastrointestinal x-ray examination revealed a large, protruded tumor with soup bubble appearance in middle portion of the stomach. Endoscopy revealed a large fungating tumor from angle to corpus of the stomach, some erosion was seen in prepyloric antrum. Grossly the tumor measured 11.0×8.5×3.5cm was soft, polypoid with broad papillary projections separated by deep fissures and was attached to the lessure curvature of the stomach. Histological diagnosis of the lesion in prepyloric antrum was IIb+IIc type early signet ring cell carcinoma and its infiltration was limited within mucosal layer, and the polypoid fungating lesion in middle portion of stomach showed a well organized villous pattern. The patient is alive and well 2 years after surgery.