EGC. EndoTODAY 이준행

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A large superficial lesion was found in the lesser curvature side of the midbody. The endoscopist gave a very unclear impression - r/o AGC, r/o EGC. I don't like this kind of description. Please make only one impression. Your guess of depth of invasion will be about 80% at best. Don't hesitate! Choose only one, either EGC or AGC!

Surgery was done.

Radical subtotal gastrectomy: Early gastric carcinoma
1. Location : middle third, Center at body and lesser curvature
2. Gross type : EGC type IIb+IIc
3. Histologic type : signet-ring cell carcinoma
4. Histologic type by Lauren : diffuse
5. Size : 5.8x3.5 cm
6. Depth of invasion : invades submucosa (sm2) (pT1b)
7. Resection margin: free from carcinoma; safety margin: proximal 1.5 cm, distal 10.5 cm
8. Lymph node metastasis : no metastasis in 60 regional lymph nodes (pN0) (0/60: "1", 0/2; "2", 0/5; "3", 0/21; "4", 0/8; "5", 0/0; "6", 0/6; "7", 0/4; "9", 0/3; "8a", 0/5; "11p", 0/2; "12a", 0/4; "4sb", 0/0)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. Peritoneal cytology : negative
13. AJCC stage by 8th edition: pT1b N0

EGC can be very large.