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[Gastric cancer 771. Small EGC IIa+IIc with SM invasion]

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Depth of invasion of IIa + IIc type of early gastric cancer (EGC) is frequently deeper than it looks. ESD was performed.


ESD: Early gastric carcinoma
1. Location : low body, lesser curvature-posterior wall
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 5 mm (2) vertical diameter, 4 mm
6. Depth of invasion : invades submucosa, (depth of sm invasion : 150 ㎛) (pT1b)
7. Resection margin : free from carcinoma(N), safety margin : distal 12 mm, proximal 9 mm, anterior 10 mm, posterior 12 mm, deep 400 ㎛
8. Lymphatic invasion : not identified(N)
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Pre-existing adenoma : none
12. Microscopic ulcer : absent
13. Histologic heterogeneity: absent

The final pathology of the ESD specimen is complete resection by expanded criteria. The pathologist classified it as EGC IIc. Anyway, careful follow-up can be chosen.

© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2019-7-29)