Abstract
An 87-year-old man admitted for lower extremity edema was found to have severe hypoproteinemia (serum total protein: 3.2g/dl, serum albumin: 1.7g/dl) and a giant elevated cauliflower lesion in the stomach. Gas-tric juice included very high protein (1, 180mg/dl), and a 99mTc-HSA protein-losing test showed the leakage of HSA into the gastric lumen. The patient was diagnosed with protein-losing gastric cancer. Administration of albumin before surgery did not prevent hypoproteinemia. Partial resection reduced the edema and hypoproteinemia. The tumor was diagnosed as early gastric cancer (papillary adenocarcinoma, sm). Surgery resulted in curability B, and no recurrence was found during 11 months of postoperative follow-up. Protein-losing gastric cancer is relatively rare, and only about 40 cases have been reported in the Japanese literature, most of which were treated with distal gastrectomy or total gastrectomy. Our case is the first undergoing partial resection of the stomach. Because patients with this disease often suffer preoperative malnutrition and early stage despite its tumor size, surgery should be minimized.
