A Case of Multiple Early Gastric Cancer with a High Level of Serum CA19-9

A 77-year-old man was admitted to our clinic with a complaint of discomfort in the upper abdomen. An upper gastrointestinal scopy revealed depressed lesion with an irregular border on the anterior side of the antrum. Histopathological examination showed a well-differentiated adenocarcinoma from the antral lesion. Preoperative blood chemical examination domonstrated a high level of serum CA19-9. Subtotal gastrectomy with DI lymphadenectomy was performed. Distant metastasis was not demonstrated. Microscopically, the resected stomach was found to have three depressed lesions. The largest lesion on the lesser curvature of the antrum invaded the submucosa and the others were limited to the mucosa. By immunohistochemical staining with anti-CA19-9 monoclonal antibody, partial expression of CA19-9 was detected. After the operation, the high level of serum CA19-9 was markably decreased to the normal serum level.