A case of synchronous triple early gastric cancers that were endoscopically resected in a lump by utilizing marginated cutting and exfoliating method

Abstract

The presented case is a 78-year-old woman who had three IIa lesions adjacent to each other at the lesser curvature of the gastric anglus. These lesions were all diagnosed as a well-differentiated adenocarcinoma by histopathological examination of the biopsy specimen. The depth of invasion was predicted to be within the mucosal layer by an endoscopic ultrasonography. They could be excised in a lump by endoscopic mucosal resection, following the marginated cutting and exfoliating method using an insulated-tip electrosurgical knife. The resected specimen was measured 45×56 mm in size ; each size of three IIa lesions was 19×11×3 mm, 20×14×4 mm, and 9×8×4 mm, respectively. All three lesions were histopathologically diagnosed as a well-differentiated adenocarcinoma localized within the mucosal layer. The patient had an uneventful postoperative course without development of any complications nor new lesions. As with this case, synchronous multiple early gastric cancers adjacent to each other could be resected in a lump by the marginated cutting and exfoliating method using an insulated-tip electrosurgical knife and this procedure could provide a complete specimen for the histopathological examination.