Four Cases of Perforative Gastric Cancer

Abstract

Perforative gastric cancer is relatively rare and treatment results are generally miserable. We treated four cases of perforative gastric cancer in the last decade. These cases accounted for 9.8% of 41 cases of perforation of the upper digestive tract and for 23.5% of 17 cases of gastric perforations in the same period. This suggests the need to consider the possibility of malignancy when gastric perforations are encountered. Tumors were located in the L region in two cases, in the M region in one case, and in the U region in the remaining case. The perforation was located on the anterior wall or on the lesser curvature. Distal gastrectomy was done in all cases. Gross tumor appearance was type 3 in three cases and type 2 in one. Pathological study showed poorly differentiated adenocarcinoma in two cases, moderately differentiated adenocarcinoma in one case, and well-differentiated adenocarcinoma in one case. Because no correct diagnosis of perforative gastric cancer was made in any of these cases, intraoperative histological examination is necessary for accurate diagnosis. Perforative gastric cancer requires curative surgery if possible.