AGC at lower body posterior wall. EndoTODAY 이준행

[Gastric cancer 878. AGC at lower body posterior wall]

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

This is a big AGC. However, it was difficult to take a good picture due to the location (lower body posterior wall).

F/66, 2018

Surgery was done.

Stomach, radical total gastrectomy: Advanced gastric carcinoma
1. Location : middle third, Center at low body, posterior wall
2. Gross type : Borrmann type 3
3. Histologic type : signet-ring cell carcinoma with extracellular mucin pool
4. Histologic type by Lauren : mixed
5. Size : 12x10 cm
6. Depth of invasion : invades serosa (pT4a)
7. Resection margin: free from carcinoma, safety margin: proximal 1.5 cm, distal 2.5 cm
8. Lymph node metastasis : metastasis to 16 out of 41 regional lymph nodes (pN3b) (perinodal extension: present) (16/41: "3.5", 10/10; "4.6", 5/8; "1", 0/0; "5", 0/2; "6", 0/6; "7", 0/2; "9", 1/1; "8a", 0/7; "11p", 0/0; "12a", 0/2; "4sb", 0/0; "2", 0/3; "10", 0/0)
9. Lymphatic invasion : present
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. Peritoneal cytology : negative
13. AJCC stage by 8th edition: pT4a N3b

The size of the tumor was bigger than the endoscopic images due to massive infiltration. The proximal resection margin was 1.5 cm, which was much less than the expectation.