Submucosal heterotopic gastric glands (HGGs) are benign lesions characterized by ectopic gastric glands in the submucosal layer and may present as submucosal tumor-like lesions. On endoscopic ultrasonography (EUS), HGGs appear as anechoic or hypoechoic areas within the second to third layers and may complicate depth assessment in the presence of gastric cancer.
Herein, we report a case of early gastric cancer with HGG in the anterior wall of the gastric angle. EUS revealed multiple anechoic areas within the second to third layers. Although mucosal cancer was suspected, lymph node enlargement on computed tomography prompted surgery. Histopathological examination revealed adenocarcinoma confined to the mucosa, with a cystically dilated HGG and no lymph node metastasis.
