A Japanese man in his 60s had undergone Billroth-II reconstruction for duodenal ulcer at 18 years of age. Five years ago, a gentle elevation at the anastomosis became prominent. This corresponded to the area of ectopic gastric glands, but no malignant findings were observed. Endoscopic examination performed 14 months ago revealed an irregular small depression over the above-mentioned elevation, and biopsy examination revealed poorly differentiated adenocarcinoma. Total resection of the residual stomach was performed. Pathological examination showed that gastric-type intramucosal carcinoma originated directly above the submucosal ectopic gastric glands and invaded the area of submucosal ectopic gastric glands.
Submucosal ectopic gastric glands may be a risk factor for gastric cancer. Careful endoscopic observation is necessary in such patients.
