A case of superficial spreading type of poorly differentiated adenocarcinoma of the stomach with invasion to the esophagus.

Adenocarcinoma of the esophagogastric junction Poorly differentiated adenocarcinoma Superficial spreading type of carcinoma of the stomach

Journal

World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544

Informations de publication

Date de publication:
29 Apr 2022
Historique:
received: 19 01 2022
accepted: 14 04 2022
entrez: 28 4 2022
pubmed: 29 4 2022
medline: 3 5 2022
Statut: epublish

Résumé

Invasion is more likely to occur in gastric cancer affecting larger areas. Poorly differentiated adenocarcinoma tends to invade deep. The cardiac region prefers submucosal invasion because the submucosa is coarser than the other regions. A 75-year-old man presented with a chief complaint of abdominal discomfort and weight loss. Esophagogastroduodenoscopy revealed an irregular ulcerative lesion with partial redness of the upper body and lesser curve of the stomach. A continuous shallow depressed lesion invaded the abdominal esophagus by approximately 40 mm. Poorly differentiated adenocarcinomas (por, sig) were observed on biopsy. Grossly, the cancer appeared to extend into the muscle layer; however, we could not confirm invasion into the muscle layer in our biopsy tissue. We diagnosed the lesion as a superficial spreading type of advanced gastric cancer and performed a total gastrectomy, D2-lymph node dissection (spleen preservation), Roux-en-Y reconstruction, and cholecystectomy. Postoperative histopathological examination revealed extensive infiltration of poorly differentiated adenocarcinoma (90 mm × 55 mm), and all were intramucosal lesions. The final pathological diagnosis was T1a, N0, M0, and Stage IA. The postoperative course was uneventful and the patient was discharged on postoperative day (POD) 11. Five years have passed since the operation, and the patient is alive without recurrence. We encountered a case of gastric carcinoma in which poorly differentiated adenocarcinomas expanded extensively. All lesions were intramucosal.

Sections du résumé

BACKGROUND BACKGROUND
Invasion is more likely to occur in gastric cancer affecting larger areas. Poorly differentiated adenocarcinoma tends to invade deep. The cardiac region prefers submucosal invasion because the submucosa is coarser than the other regions.
CASE PRESENTATION METHODS
A 75-year-old man presented with a chief complaint of abdominal discomfort and weight loss. Esophagogastroduodenoscopy revealed an irregular ulcerative lesion with partial redness of the upper body and lesser curve of the stomach. A continuous shallow depressed lesion invaded the abdominal esophagus by approximately 40 mm. Poorly differentiated adenocarcinomas (por, sig) were observed on biopsy. Grossly, the cancer appeared to extend into the muscle layer; however, we could not confirm invasion into the muscle layer in our biopsy tissue. We diagnosed the lesion as a superficial spreading type of advanced gastric cancer and performed a total gastrectomy, D2-lymph node dissection (spleen preservation), Roux-en-Y reconstruction, and cholecystectomy. Postoperative histopathological examination revealed extensive infiltration of poorly differentiated adenocarcinoma (90 mm × 55 mm), and all were intramucosal lesions. The final pathological diagnosis was T1a, N0, M0, and Stage IA. The postoperative course was uneventful and the patient was discharged on postoperative day (POD) 11. Five years have passed since the operation, and the patient is alive without recurrence.
CONCLUSION CONCLUSIONS
We encountered a case of gastric carcinoma in which poorly differentiated adenocarcinomas expanded extensively. All lesions were intramucosal.

Identifiants

pubmed: 35484561
doi: 10.1186/s12957-022-02605-2
pii: 10.1186/s12957-022-02605-2
pmc: PMC9052692
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

136

Informations de copyright

© 2022. The Author(s).

Références

Ann Surg Oncol. 2008 Jul;15(7):1959-67
pubmed: 18369676
J Gastrointest Surg. 2010 Jan;14(1):52-7
pubmed: 19821002
Medicine (Baltimore). 2016 Apr;95(14):e3242
pubmed: 27057862
Ann Surg Oncol. 1997 Mar;4(2):137-40
pubmed: 9084850

Auteurs

Junichi Mase (J)

Department of Surgery, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan. junichi.mase@gmail.com.

Takahito Adachi (T)

Department of Surgery, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan.

Shunya Kiriyama (S)

Department of Surgery, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan.

Takeshi Horaguchi (T)

Department of Surgery, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan.

Kazunori Yawata (K)

Department of Surgery, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan.

Aiko Ikawa (A)

Department of Surgery, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan.

Bun Sano (B)

Department of Surgery, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan.

Susumu Imai (S)

Department of Gastroenterology, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan.

Kiyohisa Okamoto (K)

Department of Pathology, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan.

Takashi Shiroko (T)

Department of Surgery, Japanese Red Cross Takayama Hospital, 3-11 Tenman-machi, Takayama-shi, Gifu, 506-8550, Japan.

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Classifications MeSH