A 63-year-old man with schizophrenia presented to our hospital with a chief complaint of anorexia and edema in the lower legs for the past month. Upper gastrointestinal endoscopy revealed a gross type 3 gastric carcinoma (pathology: tubular adenocarcinoma, moderately differentiated type) from the upper gastric body to the gastric antrum. His serum total protein level was 4.7 g/dL and serum albumin concentration was 1.5 g/dL. Contrast-enhanced computed tomography, magnetic resonance imaging, and examination of ascites showed no evidence of distant metastases. Hypoalbuminemia was refractory to albumin administration with no evidence of cancerous peritonitis on staging laparoscopy. Gastrointestinal scintigraphy confirmed protein leakage from the gastric tumor into the gastrointestinal tract. We reviewed the literature and identified 34 other cases of protein-losing gastric cancer, which were used to comprehensively elucidate its clinical features. Borrmann type 0 or 1 tumors of the gastric body or antecubital area, with a maximum tumor diameter of nearly 10 cm and a cauliflower-like appearance, are highly suggestive of protein-losing gastric cancer. In conclusion, 99mTc-HSA scintigraphy and staging laparoscopy should be performed aggressively to differentiate protein-losing gastric cancer tumor from cancerous peritonitis.

Mortarity due to pesticide poisoning for prefectures in Japan is examined according to the vital statistics in 1979-1981. The atlases of pesticide poisoning mortality for prefectures in Japan are presented.
There is a wide range in mortality among prefectures and the highest mortality is 17.8 times as high as that observed in the prefecture which showed the lowest mortality. Regional characteristic is observed in the mortality. Northern part of Kanto Area and the southern part of Kyusyu Island show high mortality and low mortality is observed in Hokuriku Area.
The ratio of the deaths due to pesticide poisoning to those due to automobile accident also show wide range among prefectures. The highest ratio is 38.3% and the lowest is 2.4%. The ratio shows similar regional characteristic to that observed in mortality.