Abstract
A 59-year-old woman has been undergoing treatment for asymptomatic primary biliary cirrhosis since 2003. She was admitted to our hospital because of further examination and for treatment of a gastric lesion in July, 2009. Endoscopic examination showed a normal and slightly discolored flat lesion and its extra-border was unclear. Besides, examinations had revealed almost no change for two years and three months. Histology of the biopsy specimens revealed a normal gastric mucosa in 2007 and 2008. However, in April 2009 the possibility of gastric carcinoma was suspected based on HE staining and Ki-67 immunohistochemical analysis. ESD was performed in July, 2009. Histopathology of the resected specimen revealed an extremely well differentiated adenocarcinoma [SM1, 0-IIb, ly0, v0]. The surface of mucosa consisted of normal epithelium. The tumor's phenotype was classified as gastric-type. Besides, Pepsinogen-I immunohistochemistry was positive, so this tumor was identified fundic gland type. No recurrence has been seen in our patient for about seventeen months after ESD.
