Abstract
A 57-year-old woman underwent upper gastrointestinal endoscopy screening, which showed a flat-elevated tumor (nodule-aggregating lesion), about 4 cm in size, in the fundus of the stomach. The color of the lesion was whitish. EUS showed a low echoic tumor in the first and second layers of the gastric wall. The pathological finding of the biopsy specimen showed gastric-type adenoma. Both the endoscopy and upper gastrointestinal series showed no atrophic change in the gastric mucosa. The value of the anti Helicobacter pylori (H. pylori) antibody was less than 3.0 U/mL. We diagnosed that the lesion was very well differentiated adenocarcinoma (carcinoma in situ) not associated with H. pylori infection, and performed partial gastric resection. The pathological finding of the specimen showed gastric-type adenocarcinoma (foveolar epithelial type) with a component of pyloric gland adenoma. It is rare that gastric cancer not associated with H. pylori infection originates from canceration of pyloric gland adenoma.
