Abstract
A case of gastric carcinoid tumor occurred eleven years after subtotal gastrectomy due to gastric ulcer is presented. A 62-year-old man visited the hospital because of tarry stool.
Fluoroscopy of the remnant stomach revealed a sclerosed wall at the anastomosed site. An irregular elevated lesion around the site undergoing gastroduodenostomy and stenosis in the same region with rigidity were noted by endoscopy. The patient was diagnosed as having a poorly differentiated adenocarcinoma by endoscopic biopsy.
Total gastrectomy combined with splenopancreotectomy was carried out and reconstructed with Roux-en Y method.
Histologically it was a gastric carcinoid tumor in H0P0, ss. Lymphnode metastasis was found in the sub-pyloric region.
It is considered that multiple gastric carcinoid occurring under some conditions such as pernicious anemia may directly result from continuous stimulation by gastrin, and hence, malignant change can not start in the remnant stomach after antrectomy. In terms of this, this case is rare.
