EGC IIc with a tumor island. EndoTODAY 이준행

[Gastric cancer 853. EGC IIc with a small tumor island]

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A patient with a small EGC was referred. It was described as a 10mm elevated lesion (biopsy: well differentiated adenocarcinoma).

When I reviewed more images, it was a depressed type EGC with a small elevated lesion (tumor island).

ESD was done.

ESD: Early gastric carcinoma
1. Location : antrum, 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, 16 mm (2) vertical diameter, 14 mm
6. Depth of invasion : invades mucosa (muscularis mucosa) (pT1a)
7. Resection margin : free from carcinoma(N), safety margin : distal 10 mm, proximal 10 mm, anterior 10 mm, posterior 12 mm, deep 400 ㎛
8. Lymphatic invasion : not identified(N)
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Microscopic ulcer : absent
12. Histologic heterogeneity: absent

In this case, a small elevated lesion (tumor island, Yamada II not III) was a clue for detecting early gastric cancer during the screening endoscopy. When a small lesion was found, however, we need to carefully examine the surrounding mucosa.

Anyway, you did a great job (finding a small cancer)!!!

* 참고: EndoTODAY tumor island