Preoperative diagnosis of a gastric extremely well-differentiated adenocarcinoma: A case report.
Case report
EWDA of the stomach
Endoscopic submucosal dissection
Preoperative biopsy
Submucosal tumor
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2020
2020
Historique:
received:
23
04
2020
revised:
15
07
2020
accepted:
15
07
2020
pubmed:
2
8
2020
medline:
2
8
2020
entrez:
2
8
2020
Statut:
ppublish
Résumé
Gastric adenocarcinomas with low grade atypia may be difficult to diagnose as gastric cancer by preoperative biopsy. We report an extremely well-differentiated adenocarcinoma (EWDA) of the stomach which appeared like a submucosal tumor diagnosed by preoperative endoscopic submucosal dissection. A 70-year-old male was referred with a 3-month history of a submucosal-appearing lesion in the gastric wall found on endoscopy. Biopsies of the lesion were performed and were inconclusive for neoplasia. Endoscopic ultrasonography showed a low echoic tumor growing into the fourth layer of the gastric wall. It was difficult to identify the tumor by repeat biopsy. Endoscopic submucosal dissection of the lesion was performed and revealed adenocarcinoma, and laparoscopic total gastrectomy was performed. Histopathologic evaluation showed that the tumor was stage IIA (T3N0M0). There is no recurrence 12 months after resection. Gastric EWDAs are rare lesions, accounting for 0.6% of all gastric cancers. It is difficult to diagnose gastric EWDA especially if it appears like a submucosal tumor. This lesion was finally diagnosed by endoscopic submucosal dissection. Endoscopic submucosal dissection may facilitate establishing the preoperative diagnosis of a tumor thought to be a gastric EWDA based on its endoscopic appearance and pathological findings.
Identifiants
pubmed: 32738773
pii: S2210-2612(20)30561-7
doi: 10.1016/j.ijscr.2020.07.050
pmc: PMC7533632
pii:
doi:
Types de publication
Case Reports
Langues
eng
Pagination
319-323Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Références
World J Gastroenterol. 2006 Apr 28;12(16):2510-6
pubmed: 16688795
Surg Today. 2005;35(6):488-92
pubmed: 15912298
Mod Pathol. 2013 Dec;26(12):1620-31
pubmed: 23723017
J Pathol Transl Med. 2016 Jan;50(1):71-4
pubmed: 26420250
Hum Pathol. 1999 Jul;30(7):826-32
pubmed: 10414502
Pathol Int. 2004 Nov;54(11):854-60
pubmed: 15533229
Gastric Cancer. 2013 Apr;16(2):220-32
pubmed: 22865191
Endoscopy. 2012 Oct;44(10):949-52
pubmed: 22987215
Int J Surg. 2018 Dec;60:132-136
pubmed: 30342279