[Systematic study of gastrectomy specimens for cancer, in search of synchronous carcinomas]

Multiple carcinomas were searched in 50 successive gastrectomies, 17 females (34%) 33 males (66%) from 40 to 83 years old. Macroscopic handling of the specimens included pinning on a board, fresh, half-fixed and completely fixed examination, not only by naked eye but also through a magnifying glass. The stomach were totally studied, according to Japanese method. A satisfactory slide was obtained from each block, stained with H.E. and examined by each of the authors. Synchronous tumors were found in 4 cases (8%), 3 males and one female. Compared to the main lesion, two cases showed a proximal tumor, one case showed a distal tumor, and the last one showed two tumors, one of them proximal and the other distal. Three tumors were macroscopically and two were microscopically detected. Two of them coexisted with advanced carcinoma and three with early carcinoma. Four of them were located in mucosa with intestinal metaplasia. Histologically, four cases belong to the same type of the original tumor, and one of them did not coincide. We conclude that stomachs resected for cancer must be thoroughly and methodically studied before and after fixation. We suggest that resection must include the whole mucosa with intestinal metaplasia, in order to avoid leaving a synchronous tumor in the gastric stump.