Gastric cancer. EndoTODAY

[Gastric cancer 801. EGC IIa+IIc with converging folds]

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This is an EGC IIa+IIc with converging folds. I recommended surgery.

Stomach, subtotal gastrectomy: Early gastric carcinoma
1. Location : middle third, Center at body and posterior wall
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated with mucin production (50%) and micropapillary pattern
4. Histologic type by Lauren : intestinal
5. Size : 3x2.5 cm
6. Depth of invasion :invades submucosa (sm3) (pT1b)
7. Resection margin: free from carcinoma, safety margin: proximal 2 cm, distal 8cm
8. Lymph node metastasis : no metastasis in 29 regional lymph nodes (pN0)
9. Lymphatic invasion : present (++)
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. AJCC stage by 8th edition: pT1b N0

I am not sure whether it is a mucinous gastric carcinoma or not. By WHO defintion, mucinous gastric carcinoma is "an adenocarcinoma in which a substantial amount of extracellular mucin (more than 50% of the tumor) is retained within the tumor". By Japanese defition, mucinous gastric carcinoma is "an adenocarcinoma characterized by a substantial number of mucous lakes due to mucin pooling in thr tumor stroma".