Early Detection and Successful Treatment of Gastric Carcinoma In Situ in a 60-Year-Old Male
Summary: A 60-year-old male patient experienced intermittent upper abdominal pain and bloating before meals. After undergoing a gastroscopy, he was diagnosed with gastric antrum ulcer and later confirmed with gastric carcinoma in situ through biopsy. Given the localized nature of the cancer and no signs of metastasis, the medical team recommended prompt laparoscopic radical gastrectomy. Post-surgery, the patient received supportive medication and recovered well, with complete resolution of symptoms and successful discharge.
Key Information:
- Age/Sex: 60-year-old male
- Diagnosis: Gastric Carcinoma In Situ
- Hospital: Tianjin Fifth Central Hospital
- Visit Date: July 2021
- Treatment: Laparoscopic Radical Gastrectomy + Medication (Metoclopramide Hydrochloride Injection, Bismuth Subgallate Compound Granules, Pantoprazole Sodium Injection, Fat Emulsion Injection)
- Hospitalization: 16 days, with follow-up one month later
- Outcome: Complete recovery with no residual symptoms
Initial Consultation:
In July 2021, the patient visited the clinic complaining of intermittent upper abdominal pain and bloating that worsened before meals and at night. There were no signs of nausea or vomiting. Physical examination revealed a flat and soft abdomen with normal bowel sounds and no tenderness or rebound pain. A gastroscopy was performed, which showed an antral ulcer. Biopsy results confirmed high-grade intraepithelial neoplasia with focal in situ carcinoma. Based on these findings, the patient was diagnosed with gastric carcinoma in situ and advised to undergo surgery promptly to prevent potential metastasis.
Surgical and Postoperative Care:
After admission, the patient underwent standard preoperative assessments and was cleared for laparoscopic radical gastrectomy. The procedure was performed without complications. Intraoperative findings showed a 1×0.5 cm ulcer in the antrum, with no signs of tumor invasion beyond the mucosal layer. Post-surgery pathology confirmed the cancer was confined to the mucosa, consistent with gastric in situ carcinoma. The patient was placed on intravenous medications including pantoprazole and fat emulsion for gastric protection and nutritional support. On day six, the nasogastric tube was removed, and enteral nutrition was gradually introduced. By day nine, the drainage tube was removed after an abdominal ultrasound confirmed no fluid accumulation.
Recovery and Follow-Up:
Postoperative discomfort such as bloating and mild pain was managed effectively with medication. The patient transitioned smoothly to oral intake and was prescribed bismuth subgallate granules to support mucosal healing. After 16 days of hospitalization, follow-up imaging and gastric emptying tests showed excellent recovery with no complications. The patient was discharged with instructions to return for a one-month follow-up.
Recommendations for Recovery:
Patients recovering from gastric surgery should adopt a gentle diet, avoiding spicy, cold, or hard-to-digest foods such as persimmons, hawthorns, and glutinous rice dishes. It is advisable to eat small, frequent meals during the first three months and gradually return to a regular eating pattern. Routine outpatient follow-ups are recommended for the first year, with extended intervals if no abnormalities are detected.
Importance of Early Gastric Cancer Screening:
This case highlights the critical importance of early diagnosis in gastric cancer. When detected at the in situ stage, the cure rate exceeds 95%. However, early-stage gastric cancer often presents with subtle or no symptoms, making it difficult to detect without screening. Individuals at higher risk, including those with a family history of gastric cancer, chronic atrophic gastritis, Helicobacter pylori infection, or dietary habits involving high salt intake and low fruit and vegetable consumption, should undergo annual gastroscopy. Even without these risk factors, persistent abdominal discomfort should prompt timely medical evaluation to ensure early detection and successful treatment.