A man in his 80s underwent ESD for a 30 mm-sized gastric cancer located in the greater curvature of the cardia region. Though it was diagnosed as tubular adenocarcinoma T1b, the surgical margin was positive. Additional surgical resection was proposed but not selected due to advanced age.
Five years after ESD, a 10 mm-sized submucosal tumor-like lesion was found near the post-ESD scar. Endoscopic ultrasound (EUS) revealed a hypoechoic mass contiguous with the fourth layer. Since the surface was smooth, EUS-guided fine needle aspiration (EUS-FNA) was performed for the diagnosis. The pathological finding was adenocarcinoma.
Even in tumors with little change on the mucosal surface, tissue sampling by EUS-FNA may be useful in determining the diagnosis of gastric cancer.
