Multiple Early Gastric Cancers with Diffuse Cystic Malformation Mimicking Submucosal Invasion on Endoscopic Ultrasonography: Report of a Case

Abstract

A 75-year-old man was admitted to our hospital for further investigation of multiple early gastric cancers. Three cancerous lesions were found by gastrointestinal endoscopy and biopsies confirmed well differentiated tubular adenocarcinoma. Endoscopic ultrasonography (EUS) findings suggested carcinoma of the upper gastric body invading sm2 or sm3; thus, we performed laparoscopy-assisted total gastrectomy. Interestingly, the pathological diagnosis was multiple early gastric cancer with diffuse cystic malformation (DCM) . Contrary to the preoperative diagnosis based on the EUS findings, the carcinoma of the upper gastric body existed in the mucosal layer (m) . The submucosal multiple cysts made assessing the tumor depth of invasion difficult by EUS in this case of gastric cancer with DCM. Thus, treatment should be decided only after confirming the tumor depth pathologically with endoscopic submucosal dissection.