EGC. EndoTODAY 이준행

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EGD was done 3 years after coronary stent.

The biopsy result was "atypical glands with high grade dysplasia, suggestive of tubular adenocarcinoma". What would you do? Repeating endoscopy or ESD or surgical consultation?

Based on the gross endoscopy feature, I recommended surgery without repeating endoscopy.

Stomach, radical subtotal gastrectomy: Early gastric carcinoma
1. Location : lower third, Center at distal antrum and anterior wall
2. Gross type : EGC type IIa
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size : 1.5x1.5 cm
6. Depth of invasion : invades submucosa (sm3) (pT1b)
7. Resection margin: free from carcinoma, safety margin: proximal 9.8 cm, distal 0.6 cm
8. Lymph node metastasis : no metastasis in 43 regional lymph nodes (pN0) (0/43: "3.5", 0/9; "4.6", 0/13; "1", 0/0; "5", 0/0; "6", 0/2; "7", 0/6; "9", 0/4; "8a", 0/2; "11p", 0/5; "12a", 0/2; "4sb", 0/0; "4", 0/0)
9. Lymphatic invasion : not identified
10. Venous invasion : not identified
11. Perineural invasion : not identified
12. AJCC stage by 8th edition: pT1b N0