Tumor island. EndoTODAY 이준행

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A patient with a gastric polyp, which was found in the screening endoscopy, was referred for the endoscopic treatment.

When I reviewed the outside endoscopic images, it was not a polypoid EGC, but a depressed type EGC with a small elevated lesion (tumor island). Endoscopic resection was done as usual.

ESD: Early gastric carcinoma
1. Location : angle, posterior wall
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 18 mm (2) vertical diameter, 14 mm
6. Depth of invasion : invades mucosa (lamina propria) (pT1a)
7. Resection margin : free from carcinoma(N), safety margin : distal 11 mm, proximal 4 mm, anterior 12 mm, posterior 6 mm, deep 300 ㎛
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

It is easier to find elevated lesions than depressed lesions. When a lesion was found, we need to see the surrounding mucosa carefully.

You can see more images at EndoTODAY tumor island.