Abstract
A 76-year-old who had been an outpatient of psychosurgery for apoplexy was admitted in an emergency for hematemesis. Upper gastrointestinal endoscopy showed a nodular tumor with mucin at the anterior wall of the middle of the stomach, a gross granular tumor at the posterior wall, a minimal granular polyp under the EG junction, and multiple hyperplastic polyps from the upper to middle stomach. Histopathological findings of biopsy specimens showed Group V adenocarcinoma in the nodular and granular tumors, and Group II adenoma in the granular polyp. We conducted total gastrectomy with D1+β lymphadenectomy. Final pathological findings showed tumors in the middle stomach to the moderately differentiated adenocarcinoma, sm2, and the granular polyp under the EG junction to be well differentiated adenocarcinoma, m. All lesions originated from the hyperplastic granular epithelium of the stomach. Multiple hyperplastic polyps appeared to occur to canceration might acquire to oncogenic potential. We must therefore consider all polyps of the stomach for resection.
