Abstract
The incidence of concurrence of cancer with malignant lymphoma is said to be 2-8%, the most frequent site of such complicating carcinomas being the stomach. In the case to be presented here, an attempt was made to treat multiple early cancer complicating malignant lymphoma with Nd-YAG lases under endoscopic control, with the attainment of complete disappearance of the gastric cancer as confirmed at autopsy. Cancerous lesions (III + IIc) at the gastric angulus on the lesser curvature and another situated on the posterior wall of the lower gastric body (IIc) were treated with laser, the former receiving non-contact irradiation and the latter non-contact and contact irradiation combined. A follow-up biopsy study revealed that the lesion site at the gastric angulus becoming negative for malignancy just after laser therapy, converted to positive 5 months later and then, after additional irradiation, became negative again with no further conversion to positivity thereafter. The lesion in the gastric body, which lay tangentially to laser beams and hence required combination of non-contact and contact irradiation, was totally obliter-ated by laser therapy with no later conversion to positivity on follow-up biopsy. The patient died of pneumonia despite VEP therapy while he was at the third hospitalization owing to a relapse of malignant lymphoma. At autopsy his stomach was confirmed to be entirely free of cancerous lesions with no evidence of lymph node metastasis. Endoscopic laser therapy seems to be a useful, less invasive therapeutic modality for such poor risk early stomach cancer patients as the present one.
