Abstract
Case 1 : A 63-year-old man presented at our hospital with a gastric abnormality. Gastroscopy revealed antral stenosis on the basis of a reddish irregular protruded lesion, which was determined to be adenocarcinoma by biopsy. The lesion was diagnosed to be a type 3 advanced gastric caner, and distal gastrectomy was performed. The resected specimen showed a reddish slight depressed lesion, 45 × 35 mm, in the gastric antrum. Histopathological examination revealed mucosal well-differentiated adenocarcinoma associated with diffuse submucosal heterotopic gastric glands (SHGG).
Case 2 : A 74-year-old man presented at our hospital for examination of a gastric abnormality. Gastroscopy revealed three small slightly depressed lesions in the upper gastric body, gastric angle, and lower gastric body. All these lesions were diagnosed to be early gastric cancer (0-II c), and endoscopic submucosal dissection was performed.
Histopathologically, the lesions were revealed to be mucosal or submucosal adenocarcinoma associated with cystic dilatation of SHGG. Total gastrectomy was performed. The cut surfaces of the resected specimens showed a large number of small submucosal cysts in the gastric body, and these were pathologically diagnosed as SHGG. It should be taken into consideration that early gastric cancer associated with diffuse SHGG can masquerade as advanced cancer and often develop multifocally.
