Minimally Invasive Submucosal Early Gastric Cancer that was Over-Diagnosed by Magnifying Narrow Band Imaging Endoscopy, Report of a Case Takeshi Yamashina 1 , Noriya Uedo 1 , Ryu Ishihara 1 , Kenji Aoi 1 , Noriko Matsuura 1 , Takashi Ito 1 , Mototsugu Fujii 1 , Noboru Hanaoka 1 , Sachiko Yamamoto 1 , Yoji Takeuchi 1 , Koji Higashino 1 , Hiroyasu Iishi 1 , Yasuhiko Tomita 2 1Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan 2Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan Keyword: narrow band imaging , 早期胃癌 , 深達度診断 , 拡大内視鏡 , 表面隆起型 pp.96-100
Published Date 2014/1/25
DOI https://doi.org/10.11477/mf.1403114052
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 A man in his 70's was referred to our hospital for endoscopic treatment of an early gastric cancer. Esophagogastroduodenoscopy showed a 0-IIa type superficial cancer 20mm in size at the greater curvature of the upper gastric body. The lesion had an irregular nodule, which was 5mm in size, in the proximal part of the tumor. Magnifying narrow band imaging endoscopy revealed irregular microvessels and the absence of microstructure pattern in the proximal nodule. We assumed there was submucosal invasion of the cancer at the nodule, therefore, recommended that he receive a surgical operation. Despite our strong recommendation, he insisted on undergoing ESD(endoscopic submucosal dissection). After obtaining written informed consent for the anticipated result, possible risk of complications and additional surgical resection in case of non-curative resection, ESD was undertaken for the lesion. Pathological diagnosis of the resected specimen was moderately differentiated tubular adenocarcinoma, Type 0-IIa, 23×19mm, pT1b(SM 300μm), UL(-), ly(-), v(-), pHM0, pVM0 ; and it fulfilled curative resection criteria for an expanded-indication lesion.

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