Synchronous cancers. EndoTODAY 이준행

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Two synchronous cancers were found in a young female. H. pylori serology was strong positive (31.6).

Stomach, radical total gastrectomy: Multiple gastric carcinomas (x2)
I. Advanced gastric carcinoma
1. Location : lower third, Center at antrum and lesser curvature
2. Gross type : Borrmann type 3
3. Histologic type : tubular adenocarcinoma, poorly (solid) differentiated
4. Histologic type by Lauren : diffuse
5. Size : 4x3.5 cm
6. Depth of invasion : penetrates subserosal connective tissue (pT3)
7. Resection margin: free from carcinoma, safety margin: proximal 11.5 cm, distal 2 cm
8. Lymphatic invasion : not identified
9. Venous invasion : not identified
10. Perineural invasion : present (++)
II. Advanced gastric carcinoma
1. Location : middle third, Center at body and lesser curvature
2. Gross type : EGC type IIc-like advanced
3. Histologic type : tubular adenocarcinoma, poorly (solid) differentiated
4. Histologic type by Lauren : diffuse
5. Size : 4.5x3 cm
6. Depth of invasion : invades muscularis propria (pT2)
7. Resection margin: free from carcinoma, safety margin: proximal 2.5 cm, distal 10 cm
8. Lymphatic invasion : not identified
9. Venous invasion : not identified
10. Perineural invasion : not identified
III.
1. Lymph node metastasis : no metastasis in 71 regional lymph nodes (pN0) (0/71: "1", 0/0; "2", 0/5; "3", 0/15; "4", 0/13; "5", 0/11; "6", 0/2; "7", 0/4; "9", 0/6; "8a", 0/6; "11p", 0/1; "12a", 0/2; "4sb", 0/5; perigastric LN, 0/1)
2. AJCC stage by 8th edition: pT3 N0