2010 Volume 52 Issue 5 Pages 1408-1414
A 72-year-old male was admitted to our hospital for further examination of an elevated lesion of the stomach. He had undergone endoscopy at a clinic because of abdominal fullness. The elevated lesion was found in the antrum. The biopsy specimen taken from the lesion showed well-differentiated adenocarcinoma. Endoscopy performed in our hospital revealed an elevated lesion covered with normal mucosa at the greater curvature in the antrum. Endoscopic ultrasonography showed a well demarcated hypoechoic mass in the second and third layers of the gastric wall. Histology of the biopsy specimen from the lesion revealed atrophic mucosa and no carcinoma. Since then, endoscopy, endoscopic ultrasonography and histological examination have been repeated every 2-6 months. At the 6th examination, endoscopy showed a tumor with central ulceration. Histology of the biopsy specimen revealed well-differentiated adenocarcinoma. A laparoscopy-assisted distal partial gastrectomy was performed. In the resected specimen, a tumor with ulceration measuring 20 mm in diameter was found in the antrum. Histology revealed well-differentiated adenocarcinoma with papillary growth proliferating in the submucosal layer. We report herein on a case of early gastric cancer presenting as a submucosal tumor, which had been followed-up for eighteen months.
