2022 Volume 64 Issue 4 Pages 1005-1010
The patient was a 64-year-old woman. Esophagogastroduodenoscopy for abdominal symptoms revealed a 30-mm red-colored protuberance surrounded by submucosal tumor-like elevations at the gastric fornix. On the basis of the findings obtained after total gastrectomy, she was diagnosed with advanced gastric cancer caused by a low-grade, well-differentiated gastric adenocarcinoma with the gastric phenotype on the surface. This disease often occurs in the stomach without H. pylori infection, or appears in the non- atrophic fundic gland area after H. pylori eradication. Therefore, this disease has been receiving much attention recently. Most case reports on this disease describe patients with early-stages gastric cancer, and it is considered to have a good prognosis, but we encountered a rare case of advanced cancer instead. The patient in this case showed advanced gastric cancer manifesting as a low-grade, well-differentiated gastric adenocarcinoma with the gastric phenotype on the surface and a poorly differentiated adenocarcinoma component in the deepest part, indicating a peculiar morphology. We report this case with a literature review of the endoscopic and histopathological features.
