Two Cases of Early Gastric Cancer Complicated with Liver Cirrhrosis with Hepatocellular Carcinoma Simultaneously and Successfully Treated with Endoscopic Mucosal Resection

Abstract

Two cases of liver cirrhosis (LC) with hepatocellular carcinoma (HCC) developed early gastric cancer. Follow up of esophagogastric varices by endoscopic examination detected IIc early gastric cancer.
One case was 62-year-old man and the other was 65-year-old man. Their HCCs had been already treated with transarterial embolization. Their early gastric cancers were completely resected by endoscopic mucosal resection (EMR) . Histological findings revealed moderately differentiated adenocarcinoma and that partly accompanied with poorly differentiated adenocarcinoma, respectively.
The complication of HCC with gastric cancer is reported to be relatively freguent and twenty-one cases including our two cases has been reported. These 21 cases were compared with 62 cases with early gastric cancer alone in our hospital. Seventy percent of early gastric cancer in patients with LC and HCC were located in antrum compared with 35 percent in early gastric cancer alone. Depressed type in macroscopic findings and differentiated type in histologic findings tended to be frequent. Patients with LC are usually associated with portal hypertensive gastropathy (PHG) . A causative relation of ischemic change of gastric mucosa due to PHG with gastric cancer in patients with LC could be considered.