A case of early gastric cancer after endoscopic excision for adenoma of main papilla

Abstract

An 80-year-old man was diagnosed with adenoma of the main papilla in 1999 and underwent endoscopic papillectomy in January 2003 due to disease progression. Histological findings showed a tubulovillous adenoma. At follow-up examinations, the patient underwent routine upper gastrointestinal endoscopy (GE) , MRCP and CT, with no recurrence noted. However in July 2011, GE revealed a 5 mm 0-IIc and a 12 mm 0-IIc tumor in the posterior wall of the middle and upper stomach, respectively, with histological findings of well-differentiated adenocarcinoma. Endoscopic submucosal dissection was performed for en bloc resection in October 2011. Histological findings were type 0-IIc, pT1a (M) , ly (−) , v (−) , UL (−) , pHM0, pVM0, StageI. This is a rare case of adenoma of the main papilla complicated by gastric cancer.