A CASE OF MALIGNANT ULCER HEALEC AND RECURRED THREE TIMES: REPEATED MALIGNANT CYCLES

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Stomach cancer that shows healing and recurrence of the malignant ulcer repeatedly is called malignant cycle. Malignant cycle is often difficult to differentiate from benign one endoscopically. This is a case which showed recurrence of malignant cycle for three times during three years of endoscopic observation. The patient was 42 years old when he com-plained epigastric pain and was found a small round ulcer at the gastric angle by endoscopic examination for the first time. The ulcer seemed non-malignant endoscopically and healed at the end of the 2nd month. At the 4th month, the ulcer recurred and several regenerative epithelial foci were observed in shallow ulcer. At the 8th month, the ulcer healed at a red scar. At the 20th month, the ulcer recurred apparently, but healed to be a linear scar two months later. At the 30th month, the ulcer relapsed with some irregular margin. At the 36th month, the ulcer enlarged with manifest appearance of malignant cancer. Endoscopic biopsy was carried out at the first, 2nd, and 3rd recurrence, but was positive only at the last one. The ulcer might be a mucosal cancer from the beginning. The problem was a negative biopsy either by the covering benign regenerative tissue or the failure of aiming.
社団法人日本消化器内視鏡学会の論文