EGC with unclear border. EndoTODAY 이준행

[Gastric cancer 897. EGC with unclear border]

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

This is an EGC with unclear border. The biopsy result was poorly cohesive carcinoma, signet ring cell type. What would you recommend, ESD or surgery? What is the size the lesion?

Because the border is unclear and the pathology was undifferentiated type, I recommended surgery.

Stomach, radical subtotal gastrectomy: Early gastric carcinoma
1. Location : lower third, Center at antrum
2. Gross type : EGC type IIb+IIc
3. Histologic type : tubular adenocarcinoma, poorly (poorly cohesive) differentiated
4. Histologic type by Lauren : diffuse
5. Size : 5.5x4.5 cm
6. Depth of invasion : invades mucosa (lamina propria) (pT1a)
7. Resection margin: free from carcinoma, safety margin: proximal 9 cm, distal 1.3 cm
8. Lymph node metastasis : no metastasis in 23 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: pT1a N0