
doi: 10.3919/jjsa.71.683
症例は81歳,男性.2007年5月黒色便を主訴に来院した.上部消化管内視鏡検査で胃体中部小弯に3型病変を認め,生検で中分化型腺癌であった.腫瘍マーカーは,血清CA19-9値656U/mlと著明な高値を認めた.胃癌cStage IBの術前診断で幽門側胃切除術を行った.手術時,病変は漿膜に浸潤し,2カ所の肝転移巣を認め,fStage IVであり治癒切除困難であった.標本の免疫組織学染色で,癌細胞の細胞質,間質にCA19-9の強陽性所見を認めた.術後一時的に血清CA19-9値79.5U/mlと低下したが,術後3カ月には血清CA19-9値の再上昇と共に,多発皮膚転移,肺転移をきたし,術後6カ月で永眠された.
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