Gastric cancer. EndoTODAY

[Gastric cancer 822. Rat-tailing fold in EGC]

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A middle-aged woman was referred with EGC (pathology : signet ring cell carcinoma). Multiple abnormal fold changes were seen. In particular rat tailing (= rapid tapering) was seen (interrupted yellow circle). It was clearly different from a smoothly tapered normal fold at the lower body (yellow circle).

Subtotal gastrectomy was done.

Stomach, subtotal gastrectomy: Early gastric carcinoma
1. Location : lower third, Center at body and greater curvature, posterior wall
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, poorly (poorly cohesive) differentiated with signet ring cell component
4. Histologic type by Lauren : diffuse
5. Size : 1.9x1.3 cm
6. Depth of invasion : invades submucosa (sm2) (pT1b)
7. Resection margin: free from carcinoma, safety margin: proximal 3.3 cm, distal 10 cm
8. Lymph node metastasis : no metastasis in 26 regional lymph nodes (pN0)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. AJCC stage by 8th edition: pT1b N0