Early Gastric Cancer(M), Showing SMT Like Appearance, Report of a Case Hayato Hirashima 1 , Taro Nakamichi 1 , Naoko Kitazawa 2 , Soromon Chiba 2 , Ryohei Ugaji 2 , Toshiyasu Iwao 2 , Takashi Kusakabe 3 , Michiyo Owari 4 , Hirotaka Nakashima 4 , Ryuji Nagahama 4 1Department of Gastroenterology, Utsunomiya Memorial Hospital, Utsunomiya, Japan 2Center for Gastroenterology, Aidu Chuo Hospital, Aiduwakamatsu, Japan 3Department of Pathology, Aidu Chuo Hospital, Aiduwakamatsu, Japan 4Foundation for Detection of Early Gastric Carcinoma, Tokyo Keyword: 早期胃癌 , 粘膜下腫瘍 , 内反 , 偽憩室 pp.110-117
Published Date 2014/1/25
DOI https://doi.org/10.11477/mf.1403114054
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 We report an intriguing case of early gastric intramucosal carcinoma presenting a submucosal tumor-like feature. A man in his seventies was referred to our hospital for further examination. X-ray and endoscopic examinations revealed a submucosal tumor with central depression at the posterior wall in greater curvature of the upper portion of the stomach. Two biopsies were made and the second one revealed papillary adenocarcinoma. Endoscopic ultrasonography demonstrated hypo-echoic lesion infiltrating into the third layer of the gastric wall. Thus we diagnosed sm-invasive carcinoma and proximal gastrectomy was performed. The resected specimen showed an elevated lesion measuring 15×15mm with a distinct depression in the center. The final pathological diagnosis was 0-IIc, pap, m, ly0, v0, n0, stage Ia. The thinning muscular layer of mucosa was detected surround the tumor, just as inverting submucosal layer like a pseudodiverticulum. The way of development was very intriguing.

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