Gastric cancer 1,000. EndoTODAY 이준행

[Gastric cancer 489]

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Big lesions are difficult. But tiny lesions are not easy, if it is too small.

Minute gastric cancers can be found during the screening endoscopy. A middle aged female patient was referred for the endoscopic treatment of incidentally found EGC. In the review of the initial endoscopy pictures, it looked like an erosion. Delineation of the tumor border was difficult, so ESD was done with sufficient tumor free margin. It turned out to be a 2 mm EGC limited in the lamina propria layer.

Stomach, endoscopic submucosal dissection:
Early gastric carcinoma
1. Location : body, lesser curvature
2. Gross type : EGC type IIb
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 2 mm (2) vertical diameter, 1 mm
6. Depth of invasion : invades mucosa (lamina propria) (pT1a)
7. Resection margin : free from carcinoma(N), safety margin : distal 16 mm, proximal 7 mm, anterior 14 mm, posterior 22 mm
8. Lymphatic invasion : not identified(N)
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Microscopic ulcer : absent
12. Histologic heterogeneity: absent