EndoTODAY | EndoATLAS | OPD

Parasite | Eso | Sto | Cancer | ESD

Boxim | DEX | Sono | Schedule

Home | Recent | Blog | Links


[Gastric cancer 446 - Multiple synchronous cancer missed at the initial endoscopy]

Previous | Next

001 | 101 | 201 | 301 | 401 | 501 | 601 | 701 | 801 | 901 | 1000


À§Ã¼ÁߺΠÀ§¾ÏÀ¸·Î ÀÇ·ÚµÈ È¯ÀÚ¸¦ subtotal gastrectomy·Î Ä¡·áÇϱâ À§ÇÏ¿© pre-op clipping ³»½Ã°æÀ» ÇÏ´Â °úÁ¤¿¡¼­ À§Ã¼»óºÎ¿¡¼­ fundus·Î ³Ñ¾î°¡´Â ºÎÀ§ÀÇ ¶Ç ´Ù¸¥ À§¾ÏÀÌ ¹ß°ßµÇ¾ú½À´Ï´Ù. ¾î¿ ¼ö ¾øÀÌ total gastrectomy°¡ ½ÃÇàµÇ¾ú½À´Ï´Ù. óÀ½ ¹ß°ßµÇ¾ú´ø ¾Ïº¸´Ù µÎ¹ø° ¹ß°ßµÈ ¾ÏÀÌ ´õ Å©°í ±í¾ú½À´Ï´Ù. À§¾ÏÀº Ç×»ó ´Ù¹ß¼ºÀÏ ¼ö ÀÖ½À´Ï´Ù.

ñ§: óÀ½ ¹ß°ßµÈ ¾Ï, ñé: Ãß°¡·Î ¹ß°ßµÈ ¾Ï, éÓ: clipping

Multiple gastric carcinomas (x2)

I. Early gastric carcinoma (mass 1) - ÀÌ°ÍÀÌ Ã³À½ ¹ß°ßµÈ ¾ÏÀ̾ú½À´Ï´Ù.
1. Location : upper third, Center at body and posterior wall
2. Gross type : EGC type IIc
3. Histologic type : signet-ring cell carcinoma
4. Histologic type by Lauren : mixed
5. Size : 2.2x1.4 cm
6. Depth of invasion : invades mucosa (muscularis mucosae) (pT1a)

II. Early gastric carcinoma (mass 2) - ÀÌ°ÍÀÌ clipping °úÁ¤¿¡¼­ Ãß°¡·Î ¹ß°ßµÈ ¾ÏÀ̾ú½À´Ï´Ù.
1. Location : middle third, Center at body and lesser curvature
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, poorly (poorly cohesive) differentiated
4. Histologic type by Lauren : mixed
5. Size : 3x2.8 cm
6. Depth of invasion : invades submucosa (sm3) (pT1b)

III.
1. Lymph node metastasis : no metastasis in 49 regional lymph nodes (pN0), (0/49: "3,5", 0/19; "4,6", 0/4; "2", 0/5; "5", 0/0; "6", 0/0; "7", 0/4; "9", 0/2; "8a", 0/5; "11p", 0/2; "12a", 0/5; "4sb", 0/1; "1", 0/2; "10", 0/0)
2. Lymphatic invasion : present
3. Venous invasion : not identified
4. Perineural invasion : not identified
5. Separate lesions : leiomyomas (x2) (size: 0.4x0.2 cm and 0.3x0.2 cm)
6. Resection margin : free from carcinoma, safety margin : proximal 5cm, distal 5.5cm
7. AJCC stage by 7th edition: pT1b N0



© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.