A case of gastric enteroblastic adenocarcinoma with liver metastasis about 1 year after ESD

Abstract

A patient, a male in his 70s, underwent endoscopic submucosal dissection （ESD） of gastric adenocarcinoma （pT1b, negative margin） at the previous hospital and an additional distal gastrectomy at our hospital.　One year later, a liver tumor was detected, resected, and found to be adenocarcinoma.　To determine whether the tumor was primary intrahepatic cholangiocarcinoma or metastatic gastric adenocarcinoma, we reviewed the ESD specimens from the previous hospital. Both showed clear cytoplasm and were positive for spalt-like transcription factor-4 （SALL4）.　Hence, the diagnosis was made that the primary gastric enteroblastic adenocarcinoma had metastasized to the liver.　Gastric enteroblastic adenocarcinoma is a histological subtype with a poor prognosis, and when its characteristic histology is observed, immunohistochemistry for SALL4 or other markers should be performed and the information should be conveyed to clinicians.