A CASE OF PRIMARY CANCER ARISING IN THE REMNANT STOMACH FOLLOWING PROXIMAL GASTRECTOMY

In recent years primary remnant gastric cancer after gastrectomy for benign diseases has been increasingly reported, almost of which occurred following distal gastrectomy. Only 2 cases of remnant gastric cancer after proximal gastrectomy can be seen in the literature. This paper describes an additional case after proximal gastrectomy in a 58-year-old man. There was a history of proximal gastrectomy for haemorrhagic gastric ulcer at the cardia in March, 1973. About 14 years after the operation (July 1987), the patient developed nausea and vomiting and was diagnosed as having a primary remnant gastric cancer. On September 3 total resection of the remnant stomach was carried out. Borrmann type 4 gastric carcinoma occupying the whole remnant stomach was revealed. On 12th month after surgery the patient died of recurrence to the peritoneum. Proximal gastrectomy is an interesting operative procedure which should be subjected for further examination in terms of the frequency causing anemia and gastrointestinal hormone dynamics. While it may necessitate strict follow-up entertaining a possible occurrence of remnant gastric cancer. In this paper some discussion on its etiology is also presented.