We seldom find reports describing progressive systemic sclerosis (PSS) associated with a malignant tumor in the domestic litarature. Here we present a recent case of PSS associated with gastric cancer, with some discussion from a review of the literature.
A 63-year-old woman attending our hospital for suppurative wound on both index fingures was pointed out to have anemia. Upper gastrointestinal series revealed a IIc-like advanced gastric cancer ranging from the body of the stomach to the antrum. Raynaud's symptom was present and the patient was also diagnosed as PSS. A subtotal gastrectomy was performed as to preserve some portion of the stomach, as she had an erosive lesion in the lower portion of the esophagus. Reconstruction was done by jejuno-interposition method. Only six cases or PSS associated with gastric cancer have so far been reported in Japan, including this case. It is interesting indeed, that five of the six cases had poorly differetiated adenocarcinoma, and of Borrmann type IV. Circulatory disturbance due to arterial narrowing and esophageal lesions are common in patients with PSS. Therefore, consideration for reconstructive method should be taken for the prevention of complications such as anastomotic insufficiency and esophageal stenosis due to regurgitation esophagitis.