Abstract
An 82-year-old man was admitted for diarrhea and loss of appetite. Gastrofiberscopy revealed a type 2 lesion-like submucosal tumor at the greater curvature of the upper corpus. Colonofiberscopy revealed a gastrocolic fistula leading into the stomach. Biopsy specimens from both the stomach and the colon indicated adenocarcinoma. A gastrocolic fistula was identified by abdominal CT and radiographic contrast study. On the basis of a diagnosis for gastric cancer with gastrocolic fistula, total gastrectomy, left hemicolectomy, and resection of the pancreas tail and spleen were performed. In spite of the curative operation and postoperative adjuvant chemotherapy, the patient died from recurrence 8 months later. Identification of the origin of a malignant tumor with gastrocolic fistula may often be difficult, but preoperative diagnosis is important because of the differences in operation methods and prognoses.
We believe that the macroscopic type was useful in the identification of the origin of the tumor.
