Multiple early gastric carcinomas: Clinicopathologic features and histogenesis

Isozaki, Hiroshi; Okajima, Kunio; Hu, Xiang; Fujii, Keizo; Sako, Shozo

doi:10.1002/(sici)1097-0142(19961115)78:10<2078::aid-cncr7>3.0.co;2-k

Cited by 24 publications

(12 citation statements)

References 17 publications

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“…Moreover, multiple EGC usually originate in elderly male patients with intestinal metaplasia and the histology frequently shows a welldifferentiated adenocarcinoma. 3,5,6 Unlike typical multiple EGCs, the present patient was a younger female patient with more than 10 simultaneous lesions. Moreover, all 22 metachronous lesions, including 14 synchronous lesions which originated in the remnant stomach following a gastrectomy, were signet-ring cell carcinomas.…”

Section: Discussionmentioning

confidence: 75%

“…[1][2][3][4][5][6] Although the exact preoperative diagnosis of these simultaneous lesions is mandatory for a patient's cure, it is sometimes diffi cult and approximately one third of the accessory lesions cannot be diagnosed preoperatively. 1,5,6 Therefore, a thorough preoperative examination and regular follow-up using EGD are essential for detecting these simultaneous lesions at an early stage.…”

Section: Discussionmentioning

confidence: 99%

“…However, from 5.8% to 15% of EGC presents with simultaneous multiple lesions. [1][2][3][4][5][6] Most of these simultaneous lesions would be treated if a gastrectomy was selected as a treatment. However, if EMR was selected as a treatment for the primary lesion, simultaneous lesions might be left untreated.…”

Section: Introductionmentioning

confidence: 99%

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Twenty-two metachronous multiple signet-ring cell carcinomas treated with repeated gastrectomies and repeated endoscopic mucosal resections: Report of a case

et al. 2009

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A 45-year-old Japanese woman underwent an endoscopic mucosal resection (EMR) for early gastric cancer at the Cancer Institute Hospital in July 1996. The patient then underwent a distal gastrectomy in 2002 because of a new early gastric cancer and repeated EMR for a total of six early gastric cancers in 2007. Finally, a total gastrectomy was performed in February 2008. The pathological examination of the resected specimen indicated 14 synchronous multiple early gastric cancers. Although the incidence of multiple gastric cancers has been reported to range from 5% to 15%, there is usually only a double or triple lesion. Moreover, multiple gastric cancer is typically observed in male elderly patients as differentiated adenocarcinomas. The present case was a young female patient and all of the lesions were intramucosal signet-ring cell adenocarcinomas. The carcinogenetic mechanism in this case may therefore be different from that in typical multiple gastric cancers. A thorough preoperative examination and regular postoperative follow-up are therefore essential for detecting multiple gastric cancers in their early stages.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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Twenty-two metachronous multiple signet-ring cell carcinomas treated with repeated gastrectomies and repeated endoscopic mucosal resections: Report of a case

et al. 2009

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“…The incidence of asynchronous multiple gastric carcinomas after endoscopic resection is reportedly 1.0%-5.6% [4,5]. Epidemiologically, multiple gastric carcinomas often occur in the elderly and in men, and histologically, multiple gastric carcinomas often arise in gastric mucosa with chronic gastritis, particularly severe intestinal metaplasia [6][7][8][9][10]. In regard to such characteristics, several clinicopathological risk factors for multiple carcinomas have been reported, but no clinically useful criteria are available at present for assessing the onset of multiple gastric carcinomas.…”

Section: Introductionmentioning

confidence: 99%

Study of clinicopathological factors associated with the occurrence of synchronous multiple gastric carcinomas

et al. 2009

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“…It has been reported that approximately 6% to 14% of gastric carcinomas include multiple lesions [1][2][3][4][5]. Only four patients with more than 40 synchronous gastric carcinomas have previously been reported [6].…”

Section: Introductionmentioning

confidence: 99%

A patient with 43 synchronous early gastric carcinomas with a Krukenberg tumor and pericardial metastasis

et al. 2007

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aforesaid four patients, the histological type was signetring cell carcinoma for all lesions in three patients, and moderately differentiated adenocarcinoma in the main tumor and signet-ring cell carcinoma in the other lesions in one patient.Of interest, a Krukenberg tumor is often detected in advanced gastric carcinoma but not in early gastric carcinoma. In Japan, only seven cases of gastric intramucosal carcinoma with a Krukenberg tumor have been reported since 1970 [7,8]. Pericardial metastasis from early gastric carcinoma is very rare. To our knowledge, only one case has been reported in which pericarditis carcinomatosa was initially diagnosed, and subsequently early gastric carcinoma was found [9,10]. The administration of anticancer drugs into the pericardial space has been reported to be effective for pericardial metastasis [9,11]. However, the effect was temporary and most of these patients eventually died 3-8 months after undergoing treatment.We herein report a patient with 43 synchronous early gastric carcinomas with bilateral metastatic ovarian tumors. The patient demonstrated cardiac tamponade due to pericarditis carcinomatosa, which appeared 1 year after surgery. Case reportA 53 year-old Japanese woman complained of a lower abdominal mass, and visited a local medical doctor in May 2004. She had no family history of malignancy and no signifi cant past history. Bilateral ovarian tumors were confi rmed by computed tomography (CT; Fig 1A), and metastatic tumors were thus suspected. She was referred for detailed checking and treatment to the Department of Gynecology at our hospital in July 2004, and she then consulted our department (The Department of Gastroenterological Surgery) to undergo a detailed examination of her gastrointestinal tract. AbstractA 53-year-old Japanese woman with bilateral ovarian tumors consulted our department. Gastroendoscopy disclosed 16 superfi cial depressed gastric lesions, and the histopathological diagnosis of the biopsy specimens was poorly differentiated adenocarcinoma and signet-ring cell carcinoma. Computed tomography (CT), ultrasonography (US), and positron emission tomography (PET) examinations revealed no other metastasis except for that observed in the ovaries. We performed a total gastrectomy with radical lymph node dissection and bilateral ovarian resection. A postoperative histological examination revealed 43 isolated gastric lesions which were scattered over the entire resected stomach; they were all confi ned to the mucosa. Cancer cell invasion in the lymphatics was detected only in the submucosal region beneath the main tumor. Both ovarian tumors were diagnosed as metastasis of signetring cell carcinoma (Krukenberg tumor). Adjuvant chemotherapy with irinotecan (CPT-11) and low-dose cisplatin (CDDP) was given on an outpatient basis, but 1 year after the surgery, carcinomatous pericarditis occurred. Administration of mitomycin C (MMC) into the pericardial space was performed twice; however, unfortunately, the patient died 13 months after surgery.

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Multiple early gastric carcinomas: Clinicopathologic features and histogenesis

Abstract: BACKGROUND. Multiple early gastric carcinomas were found in 5-15% of patients

Cited by 24 publications

References 17 publications

Twenty-two metachronous multiple signet-ring cell carcinomas treated with repeated gastrectomies and repeated endoscopic mucosal resections: Report of a case

Twenty-two metachronous multiple signet-ring cell carcinomas treated with repeated gastrectomies and repeated endoscopic mucosal resections: Report of a case

Study of clinicopathological factors associated with the occurrence of synchronous multiple gastric carcinomas

A patient with 43 synchronous early gastric carcinomas with a Krukenberg tumor and pericardial metastasis

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