A case of protein-losing gastric cancer treated by partial resection of the stomach

Abstract

An 82-year-old man was admitted to our hospital for lower extremity edema and dyspnea. Laboratory examination on admission revealed hypoproteinemia (serum total protein 5.0g/dl, serum albmin 3.0g/dl). His urinalysis was normal. Upper GI series, and endoscopic examinations demonstrated a giant tumor on the lesser curvature of upper middle portion of the gastric body. The surface was villous and easy bleeding. In spite of high calorie parenteral nutrition and administration of albumin, his hypoproteinemia did not improve at all (serum total protein 3.9g/dl, serum albmin 2.1g/dl). He was diagnosed as having protein-losing gastric cancer, and a partial resection of the stomach was performed. Histopathological findings showed that general stage of the disease was stage IA with invasion depth of m, n0, ly0, v0 showing villous growth. The leg edema, dyspnea and hypoproteinemia improved remarkably after the operation and no recurrence was found during 7 years of postoperative course. Protein-losing gastric cancer is rare in Japan, most of these cases were treated with distal gastrectomy or total gastrectomy because of tumor size. Our case is the second partial resection of the stomach reported in Japan.