Published online Oct 6, 2019. doi: 10.12998/wjcc.v7.i19.3138
Peer-review started: May 20, 2019
First decision: July 21, 2019
Revised: August 17, 2019
Accepted: August 27, 2019
Article in press: August 27, 2019
Published online: October 6, 2019
Submucosal tumor (SMT)-like early-stage gastric cancer (GC) has rarely been reported. It is difficult to consider the possibility of GC and differentiate it from other submucosal lesions.
We present the case of a 50-year-old male patient with a 1.6 cm SMT-like flat elevated lesion covered by congested mucosa on the gastric angle. Magnifying endoscopy with narrow-band imaging, endoscopic biopsy, endoscopic ultrasound, and computed tomography were performed for diagnosis. Endoscopic submucosal dissection and gastrectomy with lymph node dissection were performed. The post-resection pathological analysis led to a final diagnosis of GC (Bormann type I, T1bN2M0).
GC should be considered when detecting an SMT-like lesion in the stomach.
Core tip: Gastric adenocarcinoma showing features of a submucosal tumor is unusual. Preoperative diagnosis is difficult due to the generally deep location of the tumor and non-specific and overlapping features on imaging studies. In this case, esophagogastroduodenoscopy revealed a 1.6 cm type 0-Is lesion covered by congested mucosa on the gastric angle. Endoscopic ultrasound and computed tomography reveal no swollen lymph nodes and the usual biopsy cannot give a definite diagnosis. After endoscopic submucosal dissection and gastrectomy with lymph node dissection, this patient was diagnosed with GC (Bormann type I, T1bN2M0).