Abstract
We report two cases of gastric cancer associated with protein-losing gastropathy.
Case 1 : A 69-year-old man was admitted to our hospital because of loss of weight. He had a huge type 1 tumor at the gastric body and hypoproteinemia (TP 5.8g/dl, Alb 2.9g/dl). 99mTc-HSA scintigraphy showed the leakage of HSA from the tumor. He was diagnosed as having gastric cancer with protein-losing gastropathy, and distal gastrectomy was performed. His hypoproteinemia improved soon after the operation. Case 2 : A-57-year-old man was admitted to the hospital because of difficulty in swallowing. Just like the case 1, he had hypoproteinemia (TP 5.9g/dl, Alb 2.9g/dl) and a type 1 gastric tumor. Gastric cancer with protein-losing gastropathy was diagnosed by 99mTc-HAS scintigraphy. He underwent distal gastrectomy, pancreatoduodenectomy and enterostomy, because the tumor had invaded the pancreas head. The operation relieved hypoproteinemia, and no postoperative complications occurred.
Hypoproteinemia induced by this disease is intractable, and most conservative treatments are ineffective, so that early operation is important. However, we must be well-informed about that the patients with this disease invariably suffer from malnutrition and belong to a high-risk group for operation.
