Abstract
A 66-year-old Japanese man visited at our hospital for close examination for gastric lesions. Endoscopic examination revealed a flat to mildly depressed lesion about 20mm in diameter at the anterior wall of the gastric angle. When the gastric wall was expanded weakly, the lesion was more visible as a flat depressed lesion than that was expanded strongly. Biopsy specimen revealed a differentiated adenocarcinoma. The lesion was resected en bloc by endoscopic submucosal dissection method. Histologically, resected specimen revealed a medullary carcinoma with lymphoid stroma. The lesion was limited to the mucosa and the margin was free of tumor cells. Then the patient received a distal gastrectomy in our hospital. In the resected surgical specimen, neither residual lesion nor metastatic lesion was detected. Endoscopic submucosal dissection method may be useful for diagnosis and treatment of these cases limited to the mucosa.
