title: Multifocal gastric cancer with a variety of histological findings coexisting with hyperplastic polyps: report of a case.
abstract: We report a case of multifocal gastric cancer with a variety of macroscopic and histological findings. A 65-year-old woman was admitted with upper abdominal pain. Her familial history was remarkable in that her mother had died of gastric cancer. The hematological and blood biochemical values were normal, but the serum was positive for Helicobacter pylori immunoglobulin G, and the serum pepsinogen test was also positive. Gastrointestinal fiberscopy showed many granulomatous lesions coexisting with pedunculated polypoid lesions and marked atrophic gastritis throughout the stomach. We performed total gastrectomy with regional lymph node dissection. There were four separate cancers and three hyperplastic polyps with entire intestinal metaplasia. The pathological findings of these multifocal gastric cancers varied, with coexisting differentiated and undifferentiated types, and early and advanced types. One of the pedunculated polypoid lesions was accompanied by papillary adenocarcinoma. Although multifocal gastric cancer is not uncommon, the present case is considered an extremely unusual example of gastric cancer.
authors.affiliation: Fourth Department of Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ubukata
authors.forename: Motonobu
authors.initials: M
authors.lastname: Katano
authors.forename: Satoru
authors.initials: S
authors.lastname: Konishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakachi
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Goto
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakada
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tabuchi
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000368:Aged; D005260:Female; D005757:Gastritis, Atrophic / Q000150:complications / Q000473:pathology* / Q000601:surgery; D006801:Humans; D006965:Hyperplasia; D011127:Polyps / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery