Journal of Gastric Cancer  2013;13(1):65-68

doi:10.5230/jgc.2013.13.1.65

Perforated Early Gastric Cancer: Uncommon and Easily Missed a Case Report and Review of Literature.

Raymond Hon Giat LIM 1 ; Clifton Ming TAY ; Benjamin WONG ; Choon Seng CHONG ; Koji KONO ; Jimmy Bok Yan SO ; Asim SHABBIR

Affiliations

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Keywords

Stomach neoplasms; Early gastric cancer; Rupture spontaneous; Peritonitis; General surgery

Country

Republic of Korea

Language

English

Abstract

Gastric carcinoma rarely presents as a perforation, but when it does, is perceived as advanced disease. The majority of such perforations are Stage III/IV disease. A T1 gastric carcinoma has never been reported to perforate spontaneously in English literature. We present a 56 year-old Chinese male who presented with a perforated gastric ulcer. Intra-operatively, there was no suspicion of malignancy. At operation, an open omental patch repair was performed. Post-operative endoscopy revealed a macroscopic Type 0~III tumour and from the ulcer edge biopsy was reported as adenocarcinoma. Subsequently, the patient underwent open subtotal gastrectomy and formal D2 lymphadenectomy. The final histopathology report confirms T1b N0 disease. The occurrence of a perforated early gastric cancer re-emphasises the need for vigilance, including intra-operative frozen section and/or biopsy, as well as routine post-operative endoscopy for all patients.