Abstract
A 70-year-old woman, who was treated by distal gastrectomy 25 years ago, underwent an endoscopic examination. A slightly white-colored protruding tumor with an awkward shape was found in the posterior wall of the stomach near anastomosis site, and discolored and depressed lesions were located around the tumor. She was diagnosed as undifferentiated-type submucosal invasive gastric cancer of Type 0-I+IIc and underwent remnant gastrectomy. Pathologically, invasion of gastric signet-ring carcinoma cells in the submucosal layer was found over a large area of the depressed lesions. Muscularis mucosae projected out and partially raptured in a protruding part, and protruded mucosa was found in an area of the medullary growth of gastric signet-ring cell carcinoma. Carcinomatous cells slightly broke through the lamina propria in the deepest part. The etiology of protruded mucosa was thought to be a solid growth with maintenance of gastric signet-ring carcinoma cell binding.
