A CASE OF BROAD IIb TYPE EARLY GASTRIC CANCER WITH HETEROTOPIC GASTRIC MUCOSA

Abstract

We experienced a case of broad IIb type early gastric cancer with heterotopic gastric mucosa. The patient was a 63-year-old-man who was pointed out the abnormal lesion in barium meal exmination. As he admitted to our hospital, upper GI endoscopy revealed irregular, thick gastric mucosa at posterior wall of corpus. We suggested that he suffered from Borrmann 4 type advanced gastric cancer. Endoscopic ultrasonography showed multiple small cystic lesions in submucosal layer at posterior wall of corpus. The patholo-gical findings of endoscopic biopsy specimen from that lesion was poorly differenciated adenocarcinoma. We finally diagnosed broad IIb type early gastric cancer with heterotopic gastric mucosa. We performed total gastrectomy. The gastric gland, usually found in the lamina propria. That gland in the submucosa is raraly observed which could be called "heterotopic gastric mucosa" of the stomach. It has been noticed that the stomach with submucosal heterotopic gastric mucosa is frequent-ly associated with gastric cancer and high occurrence of multiple gastric cancers. However, it is rare that the heterotopic gastric mucosa itself turns malignant.