2022 Volume 60 Issue 3 Pages 375-383
A 1-cm diameter elevated lesion in the greater curvature of the gastric fundus was detected by X-ray examination of the upper gastrointestinal tract in a 47-year-old woman during our hospital's routine health check. Upon further examination, esophagogastroduodenoscopy revealed a submucosal tumor with a diameter of 1 cm, without an ulcer, at the greater curvature of the gastric fundus. Using endoscopic ultrasonography, it was diagnosed as a hypoechoic solid mass continuous with the fourth layer of the gastric wall. Immunohistochemical analysis using endoscopic ultrasonography-guided fine needle aspiration concluded a diagnosis of gastrointestinal stromal tumor (GIST), as the presence of c-KIT and CD34-positive spindle tumor cells was confirmed. Preoperative computed tomography showed no metastasis. Laparoscopy-assisted gastric wedge resection was performed. The postoperative histological diagnosis was a very low-risk GIST classified using the modified Fletcher's criteria based on the presence of 9 mm of c-KIT and a CD34-positive spindle cell tumor with 0 mitotic count per 50 high-power fields. No local recurrence or metastasis has been encountered 12 months after surgery.
