The patient was 64-year-old male with a chief complaint of epigastric discomfort. Upper GI X-ray and endoscopic examinations revealed a superficial spreading type of early gastric cancer (IIc type) on the lesser curvature of the middle body of the stomach. Total gastrectomy was performed.
Histological findings showed that the IIc type lesion diagnosed preoperatively consisted of two independent lesions, and besides there were three other lesions of IIc type of early gastric cancers undetected by examination. The two independent lesions on the lesser curvature of the middle body were a IIc type of early gastric cancer (tub2, m, ly0, v0, 22×10mm) and a IIc like type of advanced gastric cancer (muc, se, ly1, v2, 50×35mm) . Concerning the depth of invasion of three other lesions, the IIc type lesion on the anterior wall of the upper body was confined to submucosa (tub2, ly2, v0, 22×10mm) , the IIc type lesion on the anterior wall of the fornix was confined to submucosa (tub2, ly0, v0, 10×9mm) and the IIc type lesion on the posterior wall of the fornix was limited in mucosa (tub2, ly0, v0, 18×15mm) .
We reported a rare case of multiple gastric cancer with 5 lesions of which two lesions looked like a single superficial spreading IIc type of early gastric cancer.
