1999 Volume 55 Issue 2 Pages 78-79
Gastric carcinoma in the preceding stage of typical type4 gastric carcinoma was rare to encounter. In this case the main lesion was IIc-like advanced gastric carcinoma on the greater curvature of the antrum. Subtotal distal gastrectomy and D2 lymphnode dissection was done. Macroscopically the distance between the oral margin of the tumor and the surgical margin of the stomach was about 6.5cm and the surgical margin was thought to be free of carcinoma cells. But histologically carcinoma cells infiltrated scattered in the submucosal layer to the oral surgical margin. Lymphatic invasion of the carcinoma cells was not seen in the submucosal layer and fibrous change was very little. The exact detection of the oral spread of the carcinoma preoperatively had been impossible. This case was belonged type4 gastric carcinoma because the submucosal spread was very wide compared with the mucosal spread. And this case was thought to be in the preceding stage of typical type4 gastric carcinoma.
