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A Case Of Spontaneous Regression Of Advanced Gastric Cancer.

Lee et al., 2010Stomach cancer

Lee, H. S., Cheung, D. Y., Kim, J. I., Cho, S. H., Park, S. H., Han, J. Y., & Kim, J. K. (2010). A case of spontaneous regression of advanced gastric cancer. Journal of Korean medical science, 25(10), 1518–1521. https://doi.org/10.3346/jkms.2010.25.10.1518

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Abstract

An 84 yr-old male with a history of nausea and vomiting for 3 weeks was admitted to our hospital. Esopahgogastroduodenoscopy showed the diffuse infiltrative type of gastric cancer encircling from the cardia to the lower body. On abdominal computerized tomography, the gastric wall was diffusely thickened with overlying mucosal enhancement without lymph node involvement. Histologic examination revealed poorly differentiated adenocarcinoma. So surgical resection was planned. However, patient refused all medical care, and then he was discharged. He lived without any medical support and then he revisited our hospital and showed relieved symptoms on the follow-up exam. On esophagogastroduodenoscopy, the gastric mucosa of the body looked normal without any dysplastic change. Abdominal CT revealed a decreased thickening of the gastric wall of the body. The histology from the endoscopic forceps biopsy showed no evidence of malignancy. The patient is alive without any sign of tumor recurrence after 14 months.

Case Details

Disease Location

Esophagus

Personal Characteristics

84-year-old male, history of diabetes mellitus for 10 years, for which he took oral hypoglycemic agent

Clinical Characteristics

Presented with nausea and vomiting for previous 3 week, physical exam showed palpable mass at epigastrium, labs showed wbc was 7,630/μl, the hemoglobin level was 14.2 g/dl, platelet 194,000/μl, fasting glucose 140 mg/dl, blood urea nitrogen 24.6 mg/dl, creatinine 1.25 mg/dl, total protein 6.62 g/dl, albumin 3.49 g/dl, ast 18 iu/l, alt 13 iu/l, total bilirubin 0.41 mg/dl, direct bilirubin 0.18 mg/dl, alkaline phosphatase 126 iu/l, γ-gtp 11 iu/l, the prothrombin time (inr) was 1.0 and the activated partial thromboplastin time was 23.0 sec, esophagogastroduodenoscopy showed rugal fold thickening and widening along whole length of gastric body, mucosa congested and dysplastic and was friable and bled easily, biopsy showed poorly differentiated adenocarcinoma, no metastasis

Remission Characteristics

Patient refused surgical resection and chemotherapy; 6 months later esophagogastroduodenoscopy showed gastric folds well distended by air inflation, mucosa looked normal, CT scan showed decreased wall thickening, regression of perigastric infiltration, and histology showed no evidence of malignancy

Treatment & Mechanisms

Clinical Treatment

Famotidine and itopride hcl