EndoTODAY | EndoATLAS | OPD

Parasite | Eso | Sto | Cancer | ESD

Boxim | DEX | Sono | Schedule

Home | Recent | Blog | Links


[Gastric cancer 852. EGC arising from herniated gastric mucosa in the submucosa]

Previous | Next

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


Overlying mucosa of a fundus SMC became irregular, and the biopsy result was M/D tubular adenocarcinoma. What's your treatment plan?

.

.

.

.

.

.

Considering the location and shape, I thought it as an EGC arising from the surface of SMT. Surgical consultation was done for wedge resection (not for total gastrectomy)

Stomach, wedge resection: Early gastric carcinoma
1. Location : upper third, Center at fundus and greater curvature
2. Gross type : EGC type unclassifiable
3. Histologic type : tubular adenocarcinoma, well differentiated, arising from herniated gastric mucosa in the submucosa
4. Histologic type by Lauren : intestinal
5. Size : 2x1.4x1.2 cm
6. Depth of invasion : invades submucosa (sm1) (pT1b)
7. Resection margin: free from carcinoma, safety margin: 1 cm
8. Lymphatic invasion : not identified
9. Venous invasion : not identified
10. Perineural invasion : not identified
11. AJCC stage by 7th edition: T1b Nx


A few years ago, there was a similar case. (EndoTODAY À§¾Ï 60) Surgical wedge resection was performed.

- Histologic type : tubular adenocarcinoma, well differentiated
- Size : 1.5x1.5x1.0 cm
- Depth of invasion : extension to mucosa (muscularis mucosa) (pT1a)
- Resection margin: free from carcinoma
- Associated findings : herniated gastric mucosa in the submucosa

2 cm Å©±âÀÇ À§ SMT°¡ ¹ß°ßµÇ¾î ½Ã¼ú Àü Á¶Á÷°Ë»ç¿¡¼­ ¾ÏÀ¸·Î ³ª¿ÀÁö ¾ÊÀº »óÅ·ΠÀÇ·ÚµÈ È¯ÀÚÀÔ´Ï´Ù. Wedge resectionÀ» ½ÃÇàÇÏ¿´°í ³î¶ø°Ôµµ ¾Æ·¡¿Í °°Àº °á°ú°¡ ³ª¿Ô½À´Ï´Ù. Á¶Á÷°Ë»ç À§Ä¡¸¦ ¹Ù²Ù¾î º¸¾Ò´Ù¸é ¼ö¼ú Àü À§¾ÏÀ» Áø´ÜÇÒ ¼ö ÀÖÁö ¾Ê¾ÒÀ»±î »ý°¢ÇØ º¸¾Ò½À´Ï´Ù. ¿©ÇÏÆ° herniated gastric mucosa·Î ÀÎÇÏ¿© SMTó·³ À¶±âµÈ ºÎÀ§ÀÇ Á¡¸· top¿¡¼­ ¹ß»ýÇÑ À§¾ÏÀ̶ó°í °á·ÐÁö¾ú½À´Ï´Ù. Ȥ½Ã À§¾ÏÀÌ ¸ÕÀúÀÌ°í ÀÌ·Î ÀÎÇÏ¿© gastric mucosaÀÇ herniationÀÌ ¹ß»ýÇÑ °ÍÀº ¾Æ´Ò±îµµ »ý°¢ÇØ º¸¾Ò½À´Ï´Ù. ¸¶Ä¡ gastritis cystica profunda¿Í ºñ½ÁÇÏ°Ô ¸»ÀÔ´Ï´Ù. Á¤´äÀÌ ¾ø´Â Áú¹®À» È¥ÀÚ ÇØ º¸¸é¼­ ¿ô¾ú½À´Ï´Ù.


Hamartomatous inverted polyp°ú´Â ¾î¶² °ü°èÀÎÁö ±Ã±ÝÁõÀ» °¡Áö°í ÀÖ½À´Ï´Ù (EndoTODAY Hamartomatous inverted polyp). ÇöÀç±îÁö ÀúÀÇ ÃßÁ¤Àº Á¡¸·ÀÌ Á¡¸·ÇÏÃþÀ¸·Î herniationµÈ »óÅ¿¡¼­ SMT¿Í °°ÀÌ º¸ÀÏ ¼öµµ ÀÖ°í polyp °°ÀÌ º¸ÀÏ ¼öµµ ÀÖ´Â °Í °°½À´Ï´Ù. µå¹°°Ô ¾ÏÀÌ ¹ß»ýÇÒ ¼ö ÀÖ°í... ¿©ÇÏÆ° Èï¹Ì·Î¿î Áõ·ÊÀÔ´Ï´Ù.

Âü°í: EndoTODAY Hamartomatous inverted polyp

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (2020-4-15)