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An Insufficient Preoperative Diagnosis of Borrmann Type 4 Gastric Cancer in Spite of EMR 원문보기

Journal of gastric cancer : jgc, v.11 no.1, 2011년, pp.59 - 63  

Ahn, Jae-Bong (Department of Surgery, Hanyang University College of Medicine) ,  Ha, Tae-Kyung (Department of Surgery, Hanyang University College of Medicine) ,  Lee, Hang-Rak (Department of Internal Medicine, Hanyang University College of Medicine) ,  Kwon, Sung-Joon (Department of Surgery, Hanyang University College of Medicine)

Abstract AI-Helper 아이콘AI-Helper

Borrmann type 4 gastric cancers are notorious for the difficulty of finding cancer cells in the biopsy samples obtained from gastrofiberscopy. It is important to obtain the biopsy results for making surgical decisions. In cases with Borrmann type 4 gastric cancer, even though the radiological findin...

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제안 방법

  • 3). After the mucosal resection of the hypertrophic lesions of the greater curvature and the anterior wall of the body, tissues were taken by biopsy forceps from the area determined to be the submucosal layer and histological tests were performed. Nevertheless, cancer cells were not detected on the histological tests, and only the thickening of epithelial cells was observed (Fig.
  • At our hospital, for a case that cancer cells could not be detected by repeated endoscopic biopsy, we performed histological tests on the endoscopically resected gastric mucosa, but cancer cells still could not be detected. Based on the radiological test findings, the endoscopic macroscopic characteristics and the characteristics of the clinical course, we performed total gastrectomy and lymphadenectomy. The tissues obtained from the surgery were examined, and the patient’s disease was determined to be Borrmann’s type 4 gastric cancer.
  • During the follow-up observation, the clinical symptoms of the patient deteriorated, and surgery was again recommended. The patient agreed to undergo surgery and laparotomy was performed. During laparotomy, adhesion or ascites was not detected.

대상 데이터

  • A 45 years old female was admitted for nausea, vomiting and anorexia, and this had all started 6 months previously. For her past history, she was diagnosed with hypertension 10 years ago, she was diagnosed as having IgA nephropathy 5 years ago and she was taking beta-blocker, Cozaar and angiotensin converting enzyme inhibitors.
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참고문헌 (15)

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  9. 9 Kim DY Kim HR Kim YJ Kim SK Clinicopathological features of patients with Borrmann type IV gastric carcinoma ANZ J Surg 2002 72 739 742 12534387 

  10. 10 Kitamura K Beppu R Anai H Ikejiri K Yakabe S Sugimachi K Clinicopathologic study of patients with Borrmann type IV gastric carcinoma J Surg Oncol 1995 58 112 117 7844980 

  11. 11 Hamy A Letessier E Bizouarn P Paineau J Aillet G Mirallié E Study of survival and prognostic factors in patients undergoing resection for gastric linitis plastica: a review of 86 cases Int Surg 1999 84 337 343 10667814 

  12. 12 Ichiyoshi Y Maehara Y Tomisaki S Oiwa H Sakaguchi Y Ohno S Macroscopic intraoperative diagnosis of serosal invasion and clinical outcome of gastric cancer: risk of underestimation J Surg Oncol 1995 59 255 260 7630174 

  13. 13 Kinoshita T Konishi M Nakagohri T Inoue K Oda T Takahashi S Neoadjuvant chemotherapy with S-1 for scirrhous gastric cancer: a pilot study Gastric Cancer 2003 6 Suppl 1 40 44 12775019 

  14. 14 Green J Katz S Phillips G Bank S Ilardi C Hadju E Percutaneous sonographic needle aspiration biopsy of endoscopically negative gastric carcinoma Am J Gastroenterol 1988 83 1150 1153 2844079 

  15. 15 Bree RL McGough MF Schwab RE CT or US-guided fine needle aspiration biopsy in gastric neoplasms J Comput Assist Tomogr 1991 15 565 569 2061468 

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