A Case of Mucosal Cancer of the Stomach Treated by Endoscopic Submucosal Dissection after Which Nodal Metastasis Became Evident
An 82-year-old male was referred to our institution for evaluation and treatment of a protruding lesion in the stomach. Esophagogastroduodenoscopy (EGD) showed a small protruding lesion and a large superficial elevated lesion on the lesser curvature of the stomach (macroscopic type: 0-I and 0-IIa, r...
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| Format: | Article |
| Language: | English |
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2013-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2013/853849 |
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| author | Takashi Obana Naotaka Fujita Yutaka Noda Dai Hirasawa Kei Ito Toshiki Sugawara Yoshihiro Harada Tetsuya Oohira Hiroshi Honda Takashi Sawai |
| author_facet | Takashi Obana Naotaka Fujita Yutaka Noda Dai Hirasawa Kei Ito Toshiki Sugawara Yoshihiro Harada Tetsuya Oohira Hiroshi Honda Takashi Sawai |
| author_sort | Takashi Obana |
| collection | DOAJ |
| description | An 82-year-old male was referred to our institution for evaluation and treatment of a
protruding lesion in the stomach. Esophagogastroduodenoscopy (EGD) showed a small
protruding lesion and a large superficial elevated lesion on the lesser curvature of the
stomach (macroscopic type: 0-I and 0-IIa, resp.). CT and endoscopic
ultrasonography (EUS) visualized a small round lymph node (LN) 11 mm in size near
the lesser curvature, although submucosal invasion was not evident. These two lesions
were resected en bloc by endoscopic submucosal dissection (ESD). Pathological
examination of the resected specimen showed moderately differentiated tubular
adenocarcinoma (tub2) and well-differentiated tubular adenocarcinoma (tub1),
respectively, which were limited to the mucosal layer. Because lymphatic-vascular
involvement was not detected by hematoxylin and eosin (HE) staining, additional
gastrectomy was not performed. Two months after ESD, follow-up EUS and CT showed
an enlarged LN. EUS-guided fine needle aspiration (EUS-FNA) for the LN revealed
metastasis. Therefore, total gastrectomy with LN dissection was performed. His
postoperative course was uneventful. After discharge, he has been followed up at the
outpatient department without any sign of recurrence for 5 years. Histological
reexamination of the ESD specimen using immunohistochemistry showed lymphatic
invasion of cancer cells in the lamina propria of the 0-I lesion 13 mm in size. |
| format | Article |
| id | doaj-art-b02484ada7e04717be64e6c6ab673429 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-b02484ada7e04717be64e6c6ab6734292025-02-03T07:26:15ZengWileyCase Reports in Medicine1687-96271687-96352013-01-01201310.1155/2013/853849853849A Case of Mucosal Cancer of the Stomach Treated by Endoscopic Submucosal Dissection after Which Nodal Metastasis Became EvidentTakashi Obana0Naotaka Fujita1Yutaka Noda2Dai Hirasawa3Kei Ito4Toshiki Sugawara5Yoshihiro Harada6Tetsuya Oohira7Hiroshi Honda8Takashi Sawai9Department of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai 983-0824, JapanDepartment of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai 983-0824, JapanDepartment of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai 983-0824, JapanDepartment of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai 983-0824, JapanDepartment of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai 983-0824, JapanDepartment of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai 983-0824, JapanDepartment of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai 983-0824, JapanDepartment of Gastroenterology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai 983-0824, JapanDepartment of Surgery, Sendai City Medical Center, Sendai 983-0824, JapanFirst Department of Pathology, Iwate Medical University, Morioka 983-0824, JapanAn 82-year-old male was referred to our institution for evaluation and treatment of a protruding lesion in the stomach. Esophagogastroduodenoscopy (EGD) showed a small protruding lesion and a large superficial elevated lesion on the lesser curvature of the stomach (macroscopic type: 0-I and 0-IIa, resp.). CT and endoscopic ultrasonography (EUS) visualized a small round lymph node (LN) 11 mm in size near the lesser curvature, although submucosal invasion was not evident. These two lesions were resected en bloc by endoscopic submucosal dissection (ESD). Pathological examination of the resected specimen showed moderately differentiated tubular adenocarcinoma (tub2) and well-differentiated tubular adenocarcinoma (tub1), respectively, which were limited to the mucosal layer. Because lymphatic-vascular involvement was not detected by hematoxylin and eosin (HE) staining, additional gastrectomy was not performed. Two months after ESD, follow-up EUS and CT showed an enlarged LN. EUS-guided fine needle aspiration (EUS-FNA) for the LN revealed metastasis. Therefore, total gastrectomy with LN dissection was performed. His postoperative course was uneventful. After discharge, he has been followed up at the outpatient department without any sign of recurrence for 5 years. Histological reexamination of the ESD specimen using immunohistochemistry showed lymphatic invasion of cancer cells in the lamina propria of the 0-I lesion 13 mm in size.http://dx.doi.org/10.1155/2013/853849 |
| spellingShingle | Takashi Obana Naotaka Fujita Yutaka Noda Dai Hirasawa Kei Ito Toshiki Sugawara Yoshihiro Harada Tetsuya Oohira Hiroshi Honda Takashi Sawai A Case of Mucosal Cancer of the Stomach Treated by Endoscopic Submucosal Dissection after Which Nodal Metastasis Became Evident Case Reports in Medicine |
| title | A Case of Mucosal Cancer of the Stomach Treated by Endoscopic Submucosal Dissection after Which Nodal Metastasis Became Evident |
| title_full | A Case of Mucosal Cancer of the Stomach Treated by Endoscopic Submucosal Dissection after Which Nodal Metastasis Became Evident |
| title_fullStr | A Case of Mucosal Cancer of the Stomach Treated by Endoscopic Submucosal Dissection after Which Nodal Metastasis Became Evident |
| title_full_unstemmed | A Case of Mucosal Cancer of the Stomach Treated by Endoscopic Submucosal Dissection after Which Nodal Metastasis Became Evident |
| title_short | A Case of Mucosal Cancer of the Stomach Treated by Endoscopic Submucosal Dissection after Which Nodal Metastasis Became Evident |
| title_sort | case of mucosal cancer of the stomach treated by endoscopic submucosal dissection after which nodal metastasis became evident |
| url | http://dx.doi.org/10.1155/2013/853849 |
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