A 76-year-old male patient who had undergone endoscopic mucosal resection for a type 0́IIc＋IIa lesion on the lesser curvature of the lower gastric body in February 1993, was pointed out an elevated submucosal-tumor-like lesion on the anterior wall of the antrum in October 1994.
Follow up study in November 1995 showed that the tumor size enlarged and the ulceration appeared at the surface. The biopsy specimen revealed adenocarcinoma and gastrectomy was carried out. Histologically, the tumor was well differentiated adenocarcinoma and invaded to the proper muscle layer with lymph node metastasis.
The clinical course was suggestive that it was the residual cancer after endoscopic resection. But the distance between the edge of the ulcer scar and the center of tumor was 15mm, so we finaly diagnosed that the tumor was a metachronous multiple cancer.
