A Case in which Early Gastric Cancer Complicated by the Werner's Syndrome was Treated with Endoscopic Mucosal Resection

Abstract

A 53-year-old male was admitted with the left lower limb lateral condylar osteomyelitis. He was diagnosed as having diabetes mellitus with alopecia, cataract, and scleroderma at 39 years of age. Endocrinological examinations revealed insulin resistant diabetes and primary hypogonadism, and the Werner's syndrome was diagnosed.
During the course, he complained of epigastric discomfort and the endoscopic examination of the upper gastrointestinal tract revealed a IIc type early gastric cancer about 8 mm in size at the greater curvature side of the antrum, while a biopsy revealed a moderately-differentiated adenocarcinoma. The case was treated with endoscopic mucosal resection (EMR) because the healing of injury tends to prolong in the Werner's syndrome and the focus was considered to be a mucosal carcinoma smaller than 1 cm. As of now, after 2 years and 6 months, no recurrence has been observed.
The Werner's syndrome is highly complicated with malignant tumors, but most of them are melanoma and sarcoma and the complication of gastric cancer is rare. In fact, as far as we know, this is the first case in Japan in which such complications were seen with early cancer. Moreover, the indication for this case was considered to be EMR.