抄録
A 77-year-old male was admitted with appetite loss and abdominal tumor. His tumor markers were of high levels : CEA 176.2 ng/ml and CA 19-9 115.8 U/ml. Examinations such as gastrofiberscopy, CT, MRI, ultrasonography, and angiography revealed a gastric carcinoma with extraluminal growth. A distal gastrectomy was performed palliatively, as well as a resection of the infiltrated transverse colon. The operative findings were : T4, N3, H1, P0, CYX, M1 (LYM) , and Stage IV. The pathological finding of the intragastric specimen was well-differentiated adenocarcinoma (4×3.5×2.5 cm) , but one of the extraluminal growth specimens showed mucinous carcinoma (11×9×4.5 cm) . In between the gastric carcinoma and the extraluminal area, a malignant cystic area was discovered, but the connective area was not pointed out. Four months after the surgical operation, the patient died of peritonitis carcinomatosae.
We found only 79 relative case reports in the Japanese literature, with patient ages ranging from 25 to 87 with average of 60.2 years of age. The primary tumors, as per our case, originated in the greater curvature side of the antrum in most of the reported cases. Their prognoses were poor due to infiltration, or metastasis, and exceptionally, only 10 patients survived over one year. We present an extremely rare type of gastric carcinoma with extraluminal growth.
