Gastric cancer 1,000. EndoTODAY 이준행

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[2017-2-24. 애독자 질문]

50대 여성입니다. 이런 암은 조기위암인 경우가 많습니다.

Stomach, subtotal gastrectomy:
Stomach, subtotal gastrectomy:
Early gastric carcinoma
1. Location : [1] lower third, [2] middle third, Center at proximal antrum and greater curvature
2. Gross type : EGC type I
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size : 3.8x2.3 cm
6. Depth of invasion : invades mucosa (lamina propria) (pT1a)
7. Resection margin: free from carcinoma, safety margin: proximal 6.9 cm, distal 6.5 cm
8. Lymph node metastasis : no metastasis in 77 regional lymph nodes (pN0), (0/77: "1", 0/4; "3", 0/14; "5", 0/12; "4sb", 0/0; "5", 0/11; "6", 0/1; "8a", 0/12; "7", 0/9; "9", 0/4; "11p", 0/6; "12a", 0/4)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. Separate lesions : gastritis cystica profunda

수 년 후 문합부 잔위암으로 수술 (completion total gastrectomy)을 받으셨습니다.

Stomach, completion total gastrectomy:
Early gastric carcinoma
1. Location : Remnant stomach, Center at anastomosis site
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size : 2.7x1.8 cm
6. Depth of invasion : invades mucosa (lamina propria) (pT1a)
7. Resection margin: free from carcinoma, safety margin: proximal 1.2 cm, distal 8 cm
8. Lymph node metastasis : cannot be assessed
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. Peritoneal cytology : negative
13. AJCC stage by 7th edition: pT1a Nx

Completion total gastrectomy 후 anastomosis leak 발생하여 endoscopic vacuum therapy로 치료하였습니다.

* 참고: EndoTODAY 심달도 depth of invasion

* 참고: Endoscopic vacuum therapy for esophageal anastomosis site leak