IIa + IIc. EndoTODAY 이준행

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An elderly gentleman was referred for the further management of a possible EGC lesion. The review of the outside slide was "focal atypical glands, suspected tubular adenocarcinoma, W/D". Repeated biopsy after referral was "moderately differentiated adenocarcinoma."

Initial outside endoscopy: Funifilm, repeated at our institution: Olympus Q260
Stomach, radical subtotal gastrectomy: Early gastric carcinoma
1. Location : lower third, Center at antrum and postero-lesser curvature
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size : 1.0x0.8 cm
6. Depth of invasion : invades submucosa (sm3) (pT1b)
7. Resection margin: free from carcinoma, safety margin: proximal 11.5 cm, distal 0.8 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

The chance of submucosal invasion of a small IIa + IIc lesion is relatively high.