This is a report of cancer of the stomach encountered in a 71-year-old man who admitted to the hospital with complain of epigastralgia. He had undergo a two third gastrectomy with gastroduodenostomy 24 years before because of severe gastritis. For several years he had ambulatory treatment for diabetes mellitus, which was under good control. Laboratory examination revealed that red-cell count was 4,800,000, white-cell count 11,500 ; hemoglobin was 12.7gr. per 100ml, hematocrit 49.5 per cent. Total serum protein was 8.2%. The stool was positive for occult blood and the urine negative for protein. X-ray studies in barium filled stomach in upright position revealed a filling defect in the lessor curvature side. In the prone and supine double contrast studies, a lesion was visualized of irregular outline with marked surface unevenness. Endoscopically, a rough tumor resembling Borrman Type III cancer was found near the stoma on the anterior wall of gastric remnant. Marginal blending and convergency of the folds showing sudden cessation around the ulcer were recognized as well. These findings led the authors to the diagnosis of the cancer developing in the gastric remnant and total gastrectomy with esophagojejunostomia was performed. Reports of cancer in the gastric remnant detected more than 20 years after the first operation are so small in number.

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