EndoTODAY 내시경 교실
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위식도접합부암은 수술 혹은 ESD를 고민하게 만드는 예가 많습니다. 아래 두 증례는 고민을 하다가 함몰형이고 경계도 다소 애매하고 크기도 2cm 미만이 아닌 것 같아 수술을 했습니다. 둘 다 2 cm가 조금 넘는 점막암으로 나왔습니다.
. Early gastric carcinoma
1. Location : upper third, Center at cardia (Siewert II) and lesser curvature
2. Gross type : EGC type IIb
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size : 2.8x1.5 cm
6. Depth of invasion : invades mucosa (muscularis mucosa) (pT1a)
7. Resection margin: free from carcinoma
8. Lymphatic invasion : not identified
9. Venous invasion : not identified
10. Perineural invasion : not identified
11. Lymph node metastasis : no metastasis in 57 regional lymph nodes (pN0)
12. Associated findings : gastritis cystica profunda
Early gastric carcinoma
1. Location : upper third, Center at cardia (Siewert II)
2. Gross type : EGC type IIc+IIb
3. Histologic type : tubular adenocarcinoma, poorly differentiated
4. Histologic type by Lauren : diffuse
5. Size : 2.1x1.4 cm
6. Depth of invasion : invades mucosa (muscularis mucosa) (pT1a)
7. Resection margin: free from carcinoma
8. Lymph node metastasis : no metastasis in 59 regional lymph nodes (pN0)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
© 2014-11-25. 이준행