Ulcer finding. EndoTODAY 이준행

[Gastric cancer 849. Ulcer finding]

001 | 101 | 201 | 301 | 401 | 501 | 601 | 701 | 801 | 901 | 1000

Selection of ESD candidate is very tricky. The most unclear part is ulcer or ulcer findings.

In the following case, there was a definite ulcer in the initial endoscopy. In the follow-up endoscopy, ulcer crator was filled with irregular tissue, but there were subtle fold changes. The histology was moderately differentiated adenocarcinoma. What's your recommendation, ESD or surgery?

Because of the definite ulcer in the first endoscopy and the subtle ulcer finding in the follow up endoscopy, I recommended surgery. Final pathology was as followings;

Stomach, subtotal gastrectomy: Early gastric carcinoma
1. Location : middle third, Center at body and lesser curvature
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size : 2.0x1.2 cm
6. Depth of invasion : invades submucosa (sm1) (pT1b)
7. Resection margin: free from carcinoma, safety margin: proximal 2.3 cm, distal 4.5 cm
8. Lymph node metastasis : no metastasis in 42 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

Web symposium에서 비슷한 증례를 토의한 바 있어 소개합니다. 이 환자는 MM 암이었습니다.

2022-1-12

Ulcer finding은 연구마다 그 빈도가 다릅니다. 판정 기준이 다르다는 이야기입니다.

안수민 교수님 강의