A case of early duodenal bulb cancer with advanced gastric cancer (borrman 2)

A 73 years old woman was examined by gastro-duodenal endoscopy because of symptoms of appetite loss and abdominal distention. A small evated lesion (Iia like) in the anterior wall of duodenal bulb and gastric cancer (Brrman 2) in the antrum were found. Biopsy specimens showed group 5 in both leision. Radiological upper gastro-duodenal examination showed exactly the same findings. Subtotal gastrectomy and partial duodenectomy was performed. Histological examination revealed that the first lesion of duodenal bulb was poorly differenciated adenocarcinoma with invasion limited to mucosal layer. The secound lesion in stomach was moderately differenciated adenocarcinoma with invasion limited to S2. (HO and N3+). This report of early duodensl bulb cancer with advanced gastric cancer is a rare case in Japan.