Early Gastric Cancer, Type Ⅱa+Ⅱc, Perplexing in Estimation of Depth Invasion at the Central Depressed Portion. Report of a Case M. Yamaguchi 1 , S. Kawamura 1 , H. Harada 1 , N. Sakaki 1 , Y. Iida 1 , Y. Okazaki 1 , T. Takemoto 1 1The First Department of Internal Medicine, Yamaguchi University, School of Medicine pp.81-85
Published Date 1982/1/25
DOI https://doi.org/10.11477/mf.1403108687
  • Abstract
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 A 54-year-old woman visited our hospital because of transient nausea and epigastric discomfort. Endoscopic study showed a round, slightly elevated lesion on the posterior wall of the antrum. The lesion proved to be well differentiated adenocarcinoma by the biopsy specimens. X-ray investigation revealed a well demarcated oval Ⅱa+Ⅱc type early gastric cancer 20×25 mm in diameter and with 4×4 mm shallow central depression. Peripheral elevation was composed of small nodules, indicating that the invasion reached as far as the proper mucosal layer at this portion. On the other hand, barium was not effaced even by strong compression at central depression during fluoroscopy. Therefore, we thought that the tumor spread into the submucosa at the central depression, though endoscopy showed no discoloration such as redness or white coat.

 Resected specimen proved that invasion was limited to the mucosal layer. We have learned through this case that: 1. Estimation of depth invasion in Ⅱa+Ⅱc type mainly depends on the findings of the peripheral elevation. 2. Central depressed area gives few information about depth invasion, except white coat, a sign of deeper invasion. But further analytical study of central depression should be attempted, because a few exceptions to the rule exist.

Copyright © 1982, Igaku-Shoin Ltd. All rights reserved.


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