Case 1: A 70-year-old man underwent endoscopic examination for epigastric pain. Esophagogastroduodenoscopy revealed an 8-mm whitish elevated lesion at the fornix, suggesting the absence of Helicobacter pylori. Gastric adenocarcinoma of the fundic gland (GA-FG) was suspected based on the endoscopic findings and endoscopic mucosal dissection (ESD) was performed. Pathological examination demonstrated GA-FG. Case 2: A 40-year-old woman underwent endoscopic examination for epigastric distress. Esophagogastroduodenoscopy revealed a 6-mm reddish elevated lesion at the fornix. Gastric atrophy was unclear because of previous eradication therapy for Helicobacter pylori. GA-FG was suspected and ESD was performed. Pathological examination demonstrated gastric adenocarcinoma of the fundic gland mucosa (GA-FGM). Magnified narrow-band imaging is useful for preoperative diagnosis. As GA-FG and GA-FGM in particular often invade submucosal areas, ESD is preferable for curative treatment, as in our cases.
