A Case of Early Gastric Cancer Associated with Gastrointestinal Stromal Tumor and Carcinoid.

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A 78-year-pld woman complaining of heart burn was referred to the hospital with a diagnosis of type IIc early gastric cancer in March, 2001. After admission an aneurysm of the splenic artery was confirmed by a CT scan. No metastatic lesions were found. Total gastrectomy with lymph node dissection (D1+α) and, a splenectomy were performed on May 11, 2001. Abdominal exploration revealed a white nodule on the anterior surface in the gastric upper body, and an induration in the duodenum side of pyloric ring. IIc lesion in the upper gastric body was not palpable. No metastases and lymph node swelling were observed. Resected specimen disclosed three kinds of tumors. Histopathologically, the IIc lesion was diagnosed as well to moderately differentiated adenocarcinoma. Since the nodule in the serosal surface was positive for CD34 and vimentin immunohistochemically, gastrointestinal stromal tumor (GIST, uncommitted type) of the stomach was definitely diagnosed. And the induration in the pyloric ring was definitely diagnosed as carcinoid. Synchronous occurrence of gastric cancer, GIST and carcinoid is extremely rare. We report this rare case together with some bibliographical comments.
日本臨床外科学会の論文