Abstract
We report a rare case of early gastric cancer with duodenal extension. A 56-year-old woman found to have epigastric discomfort in February, 1998, was further found in gastrointestinal endoscopic examination to have a wide, continuous, granulous polypoid lesion from the prepyloric area to the duodenal bulbus. Then, she admitted our hospital. Reexamination via gastrointestinal endoscopy and biopsy upon admission showed adenocarcinoma in biopsy specimens. We then conducted gastrectomy with partial duodenectomy. Macroscopically, the resected specimen showed a I+IIa+IIc lesion which is 4cm long in the stomach and a I+IIa lesion 3.8cm long in the duodenal bulbus. The lesion consisted of well-differentiated adenocarcinoma partially mixed with moderately differentiated adenocarcinoma. Duodenal extension was almostly to the mucosa. Lymph node metastasis was not found. It is thought to be important to decide the safty resected line and sufficient area of the lymph nodes dissection.
