A Case of Gastric Cancer Resembling a Submucosal Tumor Difficulty to Diagnose Preoperatively with a Review of 183 Cases

Abstract

A 70–year–old woman with a 25 mm submucosal gastric tumor had been followed up since January 2006. During follow–up, the tumor developed a small central depression. Four endoscopic biopsies showed group I–IV. Histopathologically, biopsied tumor specimens showed low–grade dysplasia, but adenocarcinoma could not be verified. Laparoscopy–assisted distal gastrectomy was done in March 2008 becanse the possibility of marignancy could not be clinically excluded. Histopathlogically, the specimen showed well–differentiated adenocarcinoma extending to the submucosal layer and heterotopic gastric gland cancer cells. Heterotopic gastric glands showed severe submucosal layer atypia, considered early gastric cancer derived from heterotopic submucosal gastric mucosa.