Reports of H. pylori (HP) -uninfected gastric cancer have been increasing recently, but the number of HP-uninfected advanced gastric cancers remains small. Here we describe a case of HP-uninfected poorly differentiated advanced gastric cancer.
A 71-year-old woman presented with black stool. Gastroscopy (GS) revealed a type 0-IIc+III lesion on the posterior wall of the lower gastric body approximately 60 mm in size with non-atrophic background mucosa. We performed laparoscopy-assisted distal gastrectomy. The surgical specimen revealed a tumor spreading wider in the submucosal layer than the gross tumor range. The horizontal margin was positive. The final diagnosis after additional gastrectomy was poorly differentiated adenocarcinoma, Type3, pT4a (SE), INFc, Ly0, V0, pN3b, pPM0, pDM0, pStageIIIC (pT4aN3bM0). Physicians performing a GS should be aware that gastric cancer in an HP-uninfected patient could be advanced.
