Lifetime first endoscopy. EndoTODAY 이준행

[Gastric cancer 845. Lifetime first endoscopy]

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A 59 years old female patient had recurrent vomiting. Lifetime first endoscopy was done and a bizarre lesion was found. There was an obstructing lesion in the antrum, and also a very large superficial lesion was found in the body. It was difficult to make a Borrmann classification. Total gastrectomy was done.

Stomach, total gastrectomy: Advanced gastric carcinoma
1. Location : upper third, middle third and lower third, Center at whole body, anterior and posterior wall, lesser curvature
2. Gross type : Borrmann type 4
3. Histologic type : tubular adenocarcinoma, poorly (solid) differentiated and signet-ring cells
4. Histologic type by Lauren : indeterminate
5. Size : 12.0x11.5 cm
6. Depth of invasion : invades muscularis propria (pT2)
7. Resection margin: free from carcinoma, safety margin: proximal 1.0 cm, distal 0.6 cm
8. Lymph node metastasis : no metastasis in 62 regional lymph nodes (pN0) (0/62: "3", 0/15; "4", 0/14; "5", 0/2; "6", 0/6; "7", 0/6; "9", 0/2; "8a", 0/6; "11p", 0/5; "12a", 0/1; "4sb", 0/3; "1", 0/1; "2", 0/1)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. Peritoneal cytology : negative
13. AJCC stage by 8th edition: pT2 N0

The pathologist reported it as a Borrmann type IV cancer, but it is not a typical case.

적절한 검진은 참 어려운 일입니다. 어떤 분은 너무 자주 내시경 검사를 받고 있고, 어떤 분은 너무 무심하게 지내십니다. 저는 40세 이상 1-2년에 한번 내시경을 권하는 우리나라의 일반적 관행에 대체로 동의합니다. 그러나 평생 한 번도 내시경을 받지 않는 분도 계십니다.