Abstract
In late years, the adaptation of ESD for the early gastric cancer tends to be spread in Japan. According to Japanese gastric cancer treatment guidelines 2010, the early gastric cancer having a negligible risk of lymph node metastasis except absolute indication is decided as the lesion satisfying the expanded criteria. The Doctors performing ESD for the cancer satisfying the expanded criteria positively are not rare. However, we experienced the case that had lymph node metastasis although satisfying the expanded criteria for ESD. The case is female in 40s. Endoscopic examination revealed a type 0Ⅱc tumor of the 10×5mm size in the antrum of stomach, and diagnosed Group5（sig）．It was estimated to be satisfying the expanded criteria for ESD, but the patient hoped to be performed surgery as certain treatment. After surgery, pathological analysis revealed that the gastric cancer had #4d lymph node metastasis although it was 10mm size, UL（-），M, ly0, v0 and satisfied the expanded criteria for ESD. So it is very important thing that we report to patient of the metastasis risk of the cancer satisfying the expanded criteria.
