Gastric cancer. EndoTODAY

[Gastric cancer 820. EGC type I of the distal antrum]

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A large flat elevated lesion of the distal antrum was found in the screening endoscopy of the 62 years old asymptomatic female. The initial biopsy was high grade dysplasia, but irregular surface and pylorus encircling nature suggests malignancy. Repeated biopsy was well differentiated adenocarcinoma. Surgical consultation was done.

Stomach, radical subtotal gastrectomy: Early gastric carcinoma
1. Location : lower third, Center at pylorus and circle
2. Gross type : EGC type I
3. Histologic type : tubular adenocarcinoma, well differentiated
4. Histologic type by Lauren : intestinal
5. Size : 8.0x5.5 cm
6. Depth of invasion : invades mucosa (muscularis mucosae) (pT1a)
7. Resection margin: free from carcinoma, safety margin: proximal 9.0 cm, distal 1.5 cm
8. Lymph node metastasis : no metastasis in 40 regional lymph nodes (pN0) (0/40: "3,5", 0/12; "4,6", 0/8; "5", 0/0; "6", 0/3; "7", 0/3; "9", 0/0; "8a", 0/2; "11p", 0/5; "12a", 0/4; "4sb", 0/0; "1", 0/3)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. AJCC stage by 8th edition: pT1a N0