A CASE OF EARLY GASTRIC CANCER WITH WHITE VILLI-LIKE DUODENAL INVASION

Abstract

A 76-year-old woman was presented with positive fecal occult blood test. Upper GIendoscopy showed a Ila-like elevated lesion in the antrum with an invasion to bulbus andthe'biopsy revealed well-differentiated adenocarcinoma. The lesion of invading into thebulbus demonstrated a white villi-like appearance. She was admitted for subtotal gastrectomy and histological finding of excised specimen was tubular adenocarcinoma in lamina propria with infiltration to submucosa only inpyloric ring. The bulbus side of the lesion showed the histological findings of papillaryadenocarcinoma. Along with bulbus, the invasion of mucosal papillary adenocarcinomabecame gradually thin, and was extremely thin in the white villi-like lesion. Total length of bulbar invasion from pyloric ring reached 2.5 cm which appeared to bethe maximum duodenal extension among the previous reports of early gastric carcinoma.