A CASE OF PERNICIOUS ANEMIA ASSOCIATED WITH AN EARLYGASTRIC CANCER IN THE REMAINED STOMACH EIGHT YEARS AFTER THE INITIAL OPERATION FOR AN EARLY GASTRIC CANCER

Abstract

We reported here a case of pernicious anemia assosiated with an early gastric cancer in the remained stomach. A 67-year-old man with pernicious anemia had undergone gastrectomy for an early gastric cancer of type IIa on the lesser curvature of the middle gastric body in 1970. Microscopic study had cofirmed well differentiated adenocarcinoma and the oral margin of the resected stomach had been free from carcinous infiltration . Then 8 years after the initial operation, he admitted to our hospital again complaining of general fatigue and palpitation in Nov .1978. The diagnosis of the recurrence of pernicious anemia was made by the findings of the lavoratory data . Endoscopic examination revealed IIa like lesion on the lesser curvature near the cardia of the remained stomach, which was subsequently confirmed by biopsy as well differentiated adenocarcinoma . He had second operation in Oct.1979. Histological findings of this resected specimen revealed IIa type early gastric cancer, well differentiated adenocarcinoma similar to the initial cancer. The longitudinal diameter of the second lesion was 9mm. The surrouding mucosa of the second cancer had severer atrophic gastritis with intestinal metaplasia than that of the initial cancer. The second lesion was considered to be an early gastric cancer newly developed in the remained stomach.Detailes of the family history were taken from this patient His elder sister was gastrectmized for gastric cancer (Bor.III) and she had intrinsic factor antibody in serum. She was determined as latent pernicious anemia.This patient therefore a rare case of pernicious anemia associated with nonsimultaneously multiple early gastric cancers and one of his family members was a case of latent pernicious anemia associated with gastric cancer.