2009 Volume 51 Issue 4 Pages 1129-1134
A 57-year-old man was admitted to our hospital for further evaluation of the gastric tumor and submucosal tumor of the stomach. Upper gastrointestinal endoscopy showed depressed lesion on the anterior wall of the upper corpus and multiple submucosal tumor on the upper corpus to the antral part of the stomach. Biopsy specimens taken from the depressed lesion was diagnosed as gastric carcinoma. By using endoscopic ultrasonography, diffuse heterotopic gastric glands in submucosal layer were detected under the lesion of carcinoma. We conducted endoscopic submucosal dissection for the gastric carcinoma. The pathological diagnosis was well differentiated and papillary adenocarcinoma with submucosal heterotopic glands. Most of the carcinoma existed in gastric mucosal layer, but some of them invaded to submucosal layer (sm2). Furthermore, the carcinoma had multiple infiltrations to heterotopic gastric glands in submucosa. To reduce the risk of lymph node metastasis, total gastrectomy was performed. This is a rare case of early gastric carcinoma with multiple infiltrations to heterotopic gastric glands in submucosa.
