Early Gastric Cancer with Focal Differentiation to Endocrine Carcinoma, Report of a Case Yasushi Kitagawa 1,2 , Shuichi Ohara 2 , Noriyuki Iwama 3 , Hiroki Saito 2 , Yuki Ohara 2 , Takafumi Shimizu 2 , Yasuko Nezu 2 , Yasushi Tamabuchi 2 , Tomoko Handa 2 , Yutaka Kondo 2 , Akihiro Saito 2 , Manabu Shiraki 2 , Yasuhiro Kojima 2 , Shiro Hamada 2 1Shirane Gastrointestinal Clinic, Sendai, Japan 2Department of Gastroenterology, Tohoku Rosai Hospital, Sendai, Japan 3Department of Pathology, Tohoku Rosai Hospital, Sendai, Japan Keyword: 胃内分泌細胞癌 , 早期胃癌 , 拡大内視鏡 , 超音波内視鏡 , 組織発生 pp.485-494
Published Date 2017/4/25
DOI https://doi.org/10.11477/mf.1403200879
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 The patient was a 71-year-old man with a history of endoscopic treatment for esophageal cancer. Follow-up upper esophagogastroduodenoscopy revealed a depressed lesion with elevation at the periphery in the anterior wall of the gastric body. On biopsy, the lesion was diagnosed as well-differentiated adenocarcinoma. Magnified observation showed irregular granular or papillary structures with a demarcation line in the periphery of the depressed lesion. These findings were consistent with the diagnosis of well-differentiated adenocarcinoma, and the majority of the depressed lesion showed no structures suggesting the presence of poorly-differentiated adenocarcinoma. On endoscopic ultrasound, the lesion was classified as cTiB2 Although open surgery was indicated, endoscopic treatment was performed due to patient preference, and the lesion was endoscopically resected. Histological examination showed that the periphery of the depressed lesion was mainly well-differentiated adenocarcinoma while the central portion of the depressed lesion was mainly poorly-differentiated adenocarcinoma. Furthermore, the deep portion of the lesion had invaded the submucosal layer and contained cells that had differentiated into endocrine-cell carcinoma.

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