title: [Synchronous Double Cancer Involving Gastric Cancer Resembling a Submucosal Tumor with Stenosis in the Pylorus and Ascending Colon Cancer - A Case Report].
abstract: An 82-year-old woman presented to our hospital with a complaint of frequent vomiting. She was admitted for intensive examination and treatment. Abdominal computed tomography revealed that her stomach was severely expanded, and the wall of the ascending colon was thickened throughout its circumference. Upper gastrointestinal endoscopy uncovered severe stenosis in the pylorus and an elevated lesion resembling a submucosal tumor on the posterior wall of the pylorus. Biopsies of the lesion revealed that it was of Group 1. On colonoscopy, type 2 cancer was found in the ascending colon throughout the circumference, and the biopsies revealed that it was of Group 5. Upper gastrointestinal endoscopy was repeated, and the same result was obtained. The possibility of malignancy could not be excluded; therefore, distal gastrectomy and right colectomy were performed. In terms of histopathology, both resected specimens displayed poorly differentiated adenocarcinoma; however, immunohistochemical studies revealed differences in staining at the two sites. The case was diagnosed as synchronous double cancer involving gastric cancer resembling a submucosal tumor with stenosis in the pylorus and ascending colon cancer. Gastric cancer resembling a submucosal tumor is usually difficult to diagnose on biopsy. If the endoscopic findings reveal an elevated lesion resembling a submucosal tumor with stenosis, then the possibility of carcinoma should be considered, and the most suitable treatment should be selected.
authors.affiliation: Dept. of Surgery, Nagareyama Central Hospital.
authors.forename: Tatsuomi
authors.initials: T
authors.lastname: Miyauchi
authors.forename: Akira
authors.initials: A
authors.lastname: Miyaki
authors.forename: Arika
authors.initials: A
authors.lastname: Ida
authors.forename: Saki
authors.initials: S
authors.lastname: Kishibe
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
authors.forename: Takebumi
authors.initials: T
authors.lastname: Usui
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kuhara
authors.forename: Teppei
authors.initials: T
authors.lastname: Kono
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Naritaka
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery; D000369:Aged, 80 and over; D003082:Colectomy; D044682:Colon, Ascending / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D017219:Gastric Outlet Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D006801:Humans; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000601:surgery; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery