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Okumura, Yasuhiro,Takamatsu, Manabu,Ohashi, Manabu,Yamamoto, Yorimasa,Yamamoto, Noriko,Kawachi, Hiroshi,Ida, Satoshi,Kumagai, Koshi,Nunobe, Souya,Hiki, Naoki,Sano, Takeshi The Korean Gastric Cancer Association 2018 Journal of gastric cancer Vol.18 No.4
A 55-year-old man visited our hospital for a detailed examination of a gastric submucosal tumor that was first detected 10 years prior. The tumor continued to grow and had developed a depressed area in its center. A histopathological examination of biopsy specimens revealed gastric adenocarcinoma of the fundic gland type (GA-FG). It was diagnosed as T2 based on the invasion depth as determined by white-light endoscopy and endoscopic ultrasonography. A total gastrectomy with lymphadenectomy was performed and a GA-FG in the mucosa and submucosa was confirmed histopathologically. However, there was a gradual transition to an infiltrative tubular adenocarcinoma with poorly differentiated components in the muscular and subserosal layers. Metastasis was identified in a dissected lymph node (LN). This is the first report of a GA-FG progressing to an aggressive cancer with LN metastasis. These findings modify our understanding of the pathophysiology of GA-FG.
Yasuhiro Okumura,Manabu Takamatsu,Manabu Ohashi,Yorimasa Yamamoto,Noriko Yamamoto,Hiroshi Kawachi,Satoshi Ida,Koshi Kumagai,Souya Nunobe,Naoki Hiki,Takeshi Sano 대한위암학회 2018 Journal of gastric cancer Vol.18 No.4
A 55-year-old man visited our hospital for a detailed examination of a gastric submucosal tumor that was first detected 10 years prior. The tumor continued to grow and had developed a depressed area in its center. A histopathological examination of biopsy specimens revealed gastric adenocarcinoma of the fundic gland type (GA-FG). It was diagnosed as T2 based on the invasion depth as determined by white-light endoscopy and endoscopic ultrasonography. A total gastrectomy with lymphadenectomy was performed and a GA-FG in the mucosa and submucosa was confirmed histopathologically. However, there was a gradual transition to an infiltrative tubular adenocarcinoma with poorly differentiated components in the muscular and subserosal layers. Metastasis was identified in a dissected lymph node (LN). This is the first report of a GA-FG progressing to an aggressive cancer with LN metastasis. These findings modify our understanding of the pathophysiology of GA-FG.