Abstract
The patient was a 94-year-old woman who had been referred to our hospital because of anemia. Abdominal CT showed a solid tumor, 50 mm in diameter, in the duodenal bulb. Upper gastrointestinal endoscopy showed transpyloric prolapse of a type 1 gastric cancer. Her diagnosis was gastric cancer prolapsing into the duodenal bulb. Distal gastrectomy was performed, and the resected specimen was a type 1 tumor, 60 × 50 mm in size, located in the pyloric ring. Histopathological examination showed tub2 > tub1, pT2 (MP), int, INFb, ly2, v2, pN0, pPM0, pDM0, and pStage IB. Gastric tumors prolapsing into the duodenal bulb are usually early gastric cancers, while advanced gastric cancer is reportedly rare. It is possible that the tumor diameter and the presence of ball valve syndrome provided an indication for the preoperative evaluation of depth of invasion in this case.
