Three Cases of Early Cancer in the Remnant Stomach Treated by Endoscopic Mucosal Resection

Abstract

Case 1 was a 66-year-old male who had developed a type IIa cancer in the posterior wall of the remnant stomach (RS) 69 months after a distal gastrectomy for a type 2 cancer in the lower stomach. The histological type of the primary cancer was a moderately differentiated adenocarcinoma. Severe bile reflux was observed in the RS. Helicobacter Pylori (HP) was negative. Case 2 was a 33-year-old male who had developed a type IIa cancer near the suture line of the RS 8 months after a distal gastrectomy for a type IIa＋IIc cancer in the middle stomach. The histological type of the primary cancer was a well differentiated adenocarcinoma. He had a synchronous colon cancer. HP was positive. Case 3 was a 51-year-old male who had developed a type IIc cancer in the anterior wall of the RS 25 months after a laparoscopic partial gastrectomy for a type IIc cancer in the middle stomach. The histological type of the primary cancer was a well differentiated adenocarcinoma. HP was positive. The RS cancers were detected by the postoperative endoscopic examination that had been carried out once a year in case 1 and twice a year in case 3. All of the lesions in 3 cases could be treated by EMR. No recurrent lesions have been observed for 18, 14 and 10 months after EMR in cases 1, 2 and 3 respectively.
To treat the RS cancer successfully by EMR, postoperative intensive surveillance for the high-risk patients might be necessary.