A Case of Diagnosed with Pyloric Stenosis of Borrmann Type IV Gastric Cancer Exhibited Improved Stenosis following Endoscopic Nd-YAG Laser Therapy with Local Injection of Lentinan

Abstract

A 77-year-old female was admitted diagnosed with pyloric stenosis due to Borrmann type IV gastric cancer, 8 cm in size.
Abdominal ultrasound and CT scan revealed marked irregular hypertrophy of the gastric antrum with ascites. Bloodwork reveald serum IAP level of 727µg/ml. Our diagnosis did not indicate surgical treatment, however, endoscopic treatment using Nd-YAG laser irradiation of 6,988 joules (50Ｗ, 0.5sec) with local injection of 4mg Lentinan was performed each month for three months.
The patient was able to eat soft rice gruel within 5 days of the initial treatment without experiencing nausea or vomiting. Following the third treatment, upper GI series revealed partial tumor reduction, and bloodwork results indicated serum IAP level of 373µg/ml. The patient exhibited positive recovery (QOL) for 8 months, then declined due to carcinoma pleuritis and peritonitis. The patient died 12 months after the initial endoscopic treatment. Autopsy revealed diffuse hypertrophy of the gastric antrum with signet ring cell carcinoma.