A Case of Gastric Cancer with Intramural Metastasis Resembling a Submucosal Tumor

Abstract

A 79-year-old man was admitted with a complaint of an abnormality of the stomach on the right side. Abdominal computed tomography showed a submucosal tumor-like lesion that developed from the antrum of the stomach with pancreatic invasion. Endoscopic examination showed type 3 gastric cancer at the posterior wall of the gastric angle. Distal gastrectomy, body of the pancreas segmental resection, and combined submucosal tumor resection ablation were performed. Histologically, the advanced gastric cancer was diagnosed as moderately differentiated tubular adenocarcinoma. The submucosal tumor-like lesion showed similar histopathological findings. Thus, the submucosal tumor-like lesion was diagnosed as an intramural metastasis of the gastric cancer. A case in which it was difficult to preoperatively diagnose intramural metastasis of gastric cancer was presented.