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Carbohydrate antigen 19‐9‐producing early protruded gastric carcinoma prolapsing into the duodenal bulb
Author(s) -
Ishikawa Koichi,
Arita Tsuyoshi,
Shimoda Katsuhiro,
Hagino Yoshiaki,
Kitano Seigo
Publication year - 2003
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2003.00265.x
Subject(s) - medicine , curvatures of the stomach , duodenal bulb , gastroenterology , gastrectomy , papillary adenocarcinoma , stomach , adenocarcinoma , antrum , biopsy , pathology , anemia , billroth ii , carcinoma , gastric polyp , cancer , carcinoembryonic antigen
The patient was an 81‐year‐old man who was admitted to the Arita Gastrointestinal Hospital for anemia. Upper gastrointestinal series and endoscopic examinations revealed transpyloric prolapse of a pedunculated polypoid gastric carcinoma with an abnormal mucosal fold from the posterior wall of the lesser curvature of the gastric antrum. Biopsy and histological examination led to a diagnosis of papillary adenocarcinoma. The incarcerated tumor could not be restored endoscopically into the stomach, the lesion head was ulcerated, and the serum carbohydrate antigen (CA) 19‐9 was elevated to 379.7 U/mL. Surgery was indicated. Intraoperatively, the tumor was found in the duodenal bulb; it was easily manipulated into the stomach, and distal gastrectomy was performed. The tumor, 5.0 × 4.2 × 2.5 cm, was diagnosed histologically as papillary adenocarcinoma of the stomach infiltrating into the submucosal layer. The carcinoma cells stained positively for CA19‐9 antibody. The postoperative course was uneventful, the anemia improved, and the serum CA19‐9 level decreased to within normal range. The patient remains alive 15 months after the surgery. This may be the first report of a patient with Type 0 I early gastric cancer characterized by both CA19‐9 production and transpyloric prolapse.