Subtle but not so small pyloric ring cancer. EndoTODAY 이준행

[Gastric cancer 851. Subtle but not so small pyloric ring cancer]

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50 years old male was referred due to gastric cancer in the antrum.

The location and margin in the original images was very unclear. Biopsy of the repeated endoscopy was signet ring cell carcinoma.

Stomach, radical subtotal gastrectomy: Early gastric carcinoma
1. Location : lower third, Center at pylorus and greater curvature
2. Gross type : EGC type IIc
3. Histologic type : signet-ring cell carcinoma
4. Histologic type by Lauren : diffuse
5. Size : 4.5x1.0 cm
6. Depth f invasion : invades mucosa (muscularis mucosae) (pT1a)
7. Resection margin: free from carcinoma, safety margin: proximal 12.5 cm, distal 0.3 cm
8. Lymph node metastasis : no metastasis in 37 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: pT1a N0

Thank you very much for the excellent screening endoscopy. You found a mucosal cancer which must be very difficult to detect.