Abstract
A case of a gastric intramucosal carcinoma (m carcinoma) with a submucosal tumor-like (SMT-like) appearance is reported. A 64-year-old woman was found to have an SMT-like lesion in the anterior wall of the greater curvature of the upper gastric body during a medical examination. After follow-up for 1 year and 3 months, gastric carcinoma was diagnosed, and the patient was referred to our department.
Further evaluation yielded a diagnosis of gastric carcinoma cT2N0M0. A total gastrectomy with D2 lymph node dissection and a splenectomy were performed. Histopathology showed well differentiated adenocarcinoma (tub1), Type 0-I, 22×15×15 mm, PT1a, ly0, v0, pN0, pStage IA.
The muscularis mucosa was inverted from the apex like a diverticulum, and a tumor invaginating into this area was present. An intramucosal carcinoma contiguous with the muscularis mucosa was diagnosed. There has been no tumor recurrence during 4 months of postoperative follow-up.
Tumors with this appearance, even among SMT-like gastric carcinomas, are very rare, and preoperative determination of tumor depth is difficult. This case is reported along with a discussion of the the relevant literature, which includes 210 cases of SMT-like gastric carcinomas.
