Abstract
Seventy-four-year-old male underwent endoscopic mucosal resection (EMR) for double lesions of early gastric cancers. Another elevated lesion at the cardia was pointed out at the time. While strict observation with periodically repeated endoscopic biopsies did not demonstrate malignant change in gastric mucosa in the lesion. Group V was diagnosed by gastric biopsy in the lesion at 8 months after initial EMR. Since endoscopic and radiological examinations suggested invasion into the submucosal layer, whichi increase possibility of lymph node metastasis, proximal gastrectomy with D1＋α lymph node dissection was performed, preserving gastric function. Histopathological findings revealed advanced cancer with invasion into the muscularis propria. One year and two months after the surgery, EMR was performed again against early gastric cancer. We concluded that strict follow-up for metachronously developed gastric cancer will be important, in order to detect cancer at early stage, which will enable to preserve stomach, maintaining QOL, even for quadruple gastric cancers.
