A CASE OF TRIPLE EARLY GASTRIC-CANCER IN THE REMNANT STOMACH

A 63-yr-old man, who had undergone distal gastrectomy and gastrojejuno stomy (Billroth II method) 32 yr previously for duodenal ulcer, was ad mitted with suspected gastric remnant cancer, An upper gastrointestina l series and endoscopy revealed a protruding lesion at the stoma of th e remnant stomach. Total gastrectomy with resection of the adjacent je junum was performed. Histological examination demonstrated two well-di fferentiated adenocarcinomas (a mixed type I and IIc lesion with submu cosal invasion and a type IIa lesion with intramucosal invasion) and a type IIc mucocellular carcinoma located in the mucosa. Gastritis cyst ica polyposa also was observed in the remnant stomach. The combination of three early gastric cancers and gastritis cystica polyposa suggest s that the mucosa of the remnant stomach had a high malignant potentia l. The patient has survived without recurrence for 5 yr since the oper ation.