A case of protein losing gastric cancer

Abstract

A 86–year–old man was admitted to our hospital with the complaint of leg edema. Blood examination showed hypoproteinemia (total protein 3.5 g/dl) and hypoalbuminemia (serum albumin 1.6g/dl). Upper gastrointestinal series and endoscopy showed 5 large tumors from the upper corpus to the antrum of the stomach. ^99mTc–human serum albumin scintigraphy showed radio–labeled albumin accumulation in the lower third portion of the stomach. Gastric cancer with protein–losing gastroenteropathy was diagnosed, and a total gastrectomy was performed. Specimens of the resected stomach consisted of Borrman 4 type cancer (poorly–differentiated adenocarcinoma) and Borrman 1 type cancer (pappilotubular carcinoma). Histopathological findings showed that the final stage was stage IV with se, n2, H0, P0, CY1, and gastrectomy resulted in curability C. The hypoproteinemia improved soon after the operation, but the patient died of carcinomatous peritonitis 12 months after operation. We reported the case of a protein–losing gastric cancer with a review of the literature.