60-year-old man with a past history of Helicobacter pylori eradication underwent upper gastrointestinal endoscopy, and a 25 mm protruding lesion with multiple black spots was found on the posterior wall of the anglar region. We performed endoscopic submucosal dissection (ESD). The histopathological diagnosis of the ESD specimen was gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM), pT1a. It has been previously reported that some gastric adenocarcinoma of fundic-gland type may be accompanied by black spots localized within the lesion. Black spots may be a characteristic feature of gastric adenocarcinoma of fundic-gland mucosa type, and focusing on such pigmentation localized within fundic-gland mucosa may enable early detection of the tumor.
