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[Gastric cancer 660 - Borrmann type IV of the remnant stomach]
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Advanced gastric cancer Borrmann type IV can be difficult to find. It is especially true after subtotal gastrectomy. Remnant stomach is difficult to see clearly. Mucosa of the remnant stomach is usually edematous, and covered with bile-tinged fluid. Subtle mucosal changes, which are critical for the diagnosis of Borrmann type IV, cannot be noticed in this setting. As a result, Borrmann type IV of the remnant stomach is usually found in far advanced stages. Curative resection is possible only in very selected cases.
In this lady, subtle ill-defined erosive lesion was found in the lesser curvature side of the remnant stomach, and the biopsy was signet ring cell carcinoma. Surgery was done, and the tumor was 11cm in diameter. Most of the remnant stomach was infiltrated by undifferentiated-type of gastric cancer.
Left: AGC, signet ring cell carcinoma, T2N0 (proper muscle invasion)
Middle: There was no evidence of recurrence in the follow up endoscopy after surgery ( 1 year before final diagnosis of remnant gastric cancer)
Right: Remnant gastric cancer, Borrmann type IV, poorly cohesive differentiated, 11x8cm
© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2018-8-16)