A flat reddish lesion was detected in a 69-year-old man on the posterior wall of the upper gastric body by EGD. Although biopsy specimens revealed a Group4 lesion, the lesion’s margin was unclear. After four years, the same lesion showed enhanced redness with the possibility of gastric carcinoma, and the patient was referred to our hospital for further examination. Although there was no finding by NBI and biopsy specimens showed no malignancy, we performed ESD because the lesion was detected by spraying with acetic acid and indigo carmine. Microscopic examination revealed Type0-IIc, 9×5 mm, tub1＞tub2, pT1a (M) , UL (＋) , ly (−) , v (−) . We report here our clinical experience, the curative resection of the gastric cancer and the difficult diagnosis after long-term follow-up.
