Abstract
A 68-year-old man visited to our hospital after abnormality of the stomach was pointed out by gastric mass survey. Endoscopy disclosed a slightly irregular ulcer with thick whitish exudation at the lesser curvature (a little to the posterior wall side) of the middle gastric body. The biopsy specimen was Group II. He was treated with H2-blocker and cytoprotective agents. One month later, the ulcerative lesion was cicatrized. The endoscopy performed another 6 months later revealed that the lesion had changed into a protruding lesion with uneven surface and slight whitish exudation. The biopsy specimen was Group V, tub 1. Then the previous biopsy specimen was re-evaluated, and revised as Group IV. In the resected specimens, the protruding lesion was type III of Yamada's classification and a shallow depression was present in the surrounding mucosa of the fundus region, showing type I+IIc like lesion. Histologically the protruding lesion consist-ed of papillary adenocarcinoma. The cancer cells in stem lesion inveded into submucosal layer and of the shallow depressed lesion into mucosal layer. This case, which was transformed from depressed type to protruding type in a short period of 7 months, is extremely rare. And this is considered to be an important case with special reference to the influence of H2-blocker.
