Gastric cancer. EndoTODAY

[Gastric cancer 797. Is it an EGC or an AGC?]

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In the screening endoscopy for a young adult, a small elevated with central depression was found. The edge was discrete except hyperemia at 3 to 6 o'clock direction. The pathology was poorly cohesive carcinoma with signet ring cell feature.

Repeated endoscopy after referral showed similar images. The endoscopist (1st year fellow) guessed it would be an AGC, but I was not sure.

Advanced gastric cancer B-I
#1×6(AW of low body)
- Location : anterior wall of low body
- Size : 2 cm
- LB AW side 에 2cm sized protrusing mass with central depression 이 관찰되며, 중앙부위는 irregular edge 와 whitish exudate 를 보임

Final patholgy after surgery was as follows.

Stomach, subtotal gastrectomy: Advanced gastric carcinoma
1. Location : lower third, Center at body and anterior wall
2. Gross type : Borrmann type 2
3. Histologic type : tubular adenocarcinoma, poorly (poorly cohesive) differentiated
4. Histologic type by Lauren : diffuse
5. Size : 1.8x1.5 cm
6. Depth of invasion : invades muscularis propria (pT2)
7. Resection margin: free from carcinoma, safety margin: proximal 3.4 cm, distal 5 cm
8. Lymph node metastasis : metastasis to one out of 47 regional lymph nodes (pN1), (perinodal extension: absent) (1/47: "3", 1/11; "4", 0/11; "5", 0/2; "6", 0/5; "7", 0/4; "9", 0/2; "8a", 0/4; "11p", 0/5; "12a", 0/1; "4sb", 0/1; "1", 0/1)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. Peritoneal cytology : negative

You did a good job, Dr. Yoo.