A 70-year-old man who visited our hospital with low platelet count and positive serum H. pylori antibodies, a condition which had persisted for 10 years. Based on blood test results at the first visit, the patient was diagnosed with immune thrombocytopenia (ITP). Upper gastrointestinal endoscopy performed before H. pylori eradication revealed 0-IIc in the posterior wall of the upper greater curvature of the gastric body. Since endoscopic treatment for greater curvature of the gastric body would not be able to control bleeding, H. pylori eradication was first performed in anticipation of an increase in platelet count. One month after eradication treatment, platelet count rose to 128,000/μL, indicating endoscopic submucosal dissection (ESD). As expected, major bleeding occurred during the treatment, but en bloc excision of the lesion was possible without complications. No bleeding occurred after ESD. Histopathological diagnosis was 0-IIc, 30×27 mm, tub1, pT1b (SM1 130 μm), ly0, v0, pUL (-), pHM0, pVM0. We report a case of early gastric cancer associated with ITP in which ESD was safely performed after H. pylori eradication.
