1998 Volume 40 Issue 10 Pages 1864-1871
In a 57-year-old man, abnormal findings at the lesser curvature of the lower gastric body was detected in a health check-up. Endoscopic examination revealed type III+IIc lesion at same portion. Histological examination of the biopsied specimen revealed adenocarcinoma cells. After three times of endoscopic examination, the patient was introdeced and admitted to our hospital. Double contrast study revealed a IIa+IIc lesion with central elevation at the lesser curvature aspect of the lower gastric body. Endoscopic findings revealed a ha + IIc with central elevation. The Shape of the lesion changed from III + IIc to ha + IIc during the three months. The value of alpha-f etoprotein elevated from 7.8 ng/ml on the initial health check-up to 147.6 on admission. Because of lympha-denopathy at the No. 1 portion, total gastrectomy was performed. Histological examina-tion of the resected specimen showed papillary and solid tumor of poorly differentiated adenocarcinoma which was massively invaded into the submucosal layer (sm 3). The part of poorly differentiated adenocarcinoma in the submucosal layer was positive for im-muological staining of alpha-fetoprotein except the part of papillary adenocarcinoma in the mucosal layer. Based on a review of the literature, this is the first case of early gastric cancer that changed in its form in a short time with elevation of AFP value.
