Advanced Gastric Carcinoma Predominantly Composed of Poorly Differentiated Adenocarcinoma Presenting as a Subpedunculated Protrusion, Report of a Case Tomoaki Moriyama 1,5 , Kousei Fukuda 1 , Hideto Taniguchi 1 1Department of Internal Medicine, Okayama Kyoritsu Hospital Keyword: 低分化腺癌 , 1型進行胃癌 , 胃内視鏡 pp.827-832
Published Date 2004/4/25
DOI https://doi.org/10.11477/mf.1403100466
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 A53-year-old Japanese man was admitted to our hospital for the purpose of treatment of a polypoid tumor of the stomach, found incidentally by gastroscopy. The endoscopic examination revealed a subpedunculated nodular tumor accompanied by a flat area and a shallow depression at the margin of the protrusion, on the anterior wall of the upper body. Biopsy specimens taken from the tumor disclosed poorly differentiated adenocarcinoma. A double contrast x-ray study showed a protruding tumor composed of two nodular components, with a deformity seen on the lateral view. Endoscopic ultrasonography demonstrated the tumor to be a hypoechoic mass with massive invasion of the submucosa and possibly of the muscularis propria. The protruding lesion, after total gastrectomy, revealed a polypoid tumor measuring2.0×1.5cm in size with a slightly depressed area. Histopathology showed a poorly differentiated adenocarcinoma coexistent with signet-ring cell carcinoma with invasion of the muscularis propria. When making an endoscopic diagnosis of the protruding-type gastric carcinoma, it is important to observe not only the the protrusion but also the margin of the tumor.

 1) Department of Internal Medicine, Okayama Kyoritsu Hospital,Okayama, Japan

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