Gastric cancer. EndoTODAY

[Gastric cancer 782. Small EGC with deep SM invasion]

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Small gastric cancer can have deep SM invasion.

ESD : Early gastric carcinoma
1. Location : high body, posterior wall
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated with serrated feature
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 6 mm (2) vertical diameter, 6 mm
6. Depth of invasion : invades submucosa, (depth of sm invasion : 1200 ㎛) (pT1b)
7. Resection margin : involved deep resection margin by carcinoma with cauterized artifact negative other resection margins; safety margin : distal 3 mm, proximal 2 mm, anterior 16 mm, posterior 4 mm, deep 0 ㎛
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

Becuase of the deep SM invasion and positive vertical margin, additional surgical treatment was recommended.

The meaning of the serrated feature in the gastric neoplasm is still unclear.

* Reference: EndoTODAY serrated adenoma/cancer of the stomach