title: Gastric cancer mimicking a submucosal tumor diagnosed by laparoscopic excision biopsy.
abstract: We report a case of advanced gastric cancer exhibiting the features of a submucosal tumor (SMT) of the gastric body. The patient was a 50-year-old male in whom a gastric SMT was detected during a mass screening examination. Upper gastrointestinal endoscopy revealed a protuberant tumor, 2 cm in diameter, covered with normal-appearing mucosa. Examination of an endoscopic biopsy specimen of the tumor revealed chronic gastritis with regenerative and erosive changes. An endoscopic ultrasound examination demonstrated a hypoechoic mass in the third layer of the gastric wall. The clinical diagnosis was gastric SMT, and the patient's course was monitored. Twenty-six months after the initial visit to our hospital, an endosonograph-guided biopsy revealed Group III (borderline lesion). Three months after the biopsy, the size of the SMT had increased slightly. Laparoscopic wedge resection of the tumor was performed to make a pathologic diagnosis and we were able to make a diagnosis of gastric lymphoepithelioma-like carcinoma intraoperatively. Gastrectomy with lymph node dissection was followed as curative surgery. Laparoscopic total excision biopsy is a useful technique in patients with a gastric SMT whose diagnosis has not been confirmed pathologically.
authors.affiliation: Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Takahashi
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Otani
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Furukawa
authors.forename: Kaori
authors.initials: K
authors.lastname: Kameyama
authors.forename: Yasutada
authors.initials: Y
authors.lastname: Akiba
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Saikawa
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kubota
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kumai
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kuramochi
authors.forename: Makio
authors.initials: M
authors.lastname: Mukai
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ishii
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D019160:Endosonography; D005756:Gastritis / Q000473:pathology; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery