Extremely well differentiated adenocarcinoma of the stomach diagnosed preoperatively as esophageal achalasia: report of a case.
Extremely well differentiated primary gastric adenocarcinoma, which accounts for less than 0.2% of all gastric cancers, is associated with a better prognosis than other types of differentiated adenocarcinoma. Among 2070 gastric carcinomas, diagnosed between 1983 and 2002 at Fukuoka University Hospital and Hamanomachi Hospital, there were three cases of primary extremely well differentiated adenocarcinoma. We report the clinicopathological details of one case of primary gastric extremely well differentiated adenocarcinoma. A 57-year-old man was reffered to our hospital for investigation and treatment of a gastric tumor. Physical and laboratory examinations revealed no abnormalities except for diabetes mellitus. Radiological, endoscopic, and imaging examinations showed an esophageal achalasia-like stenotic lesion. The surface mucosa consisted of almost normal epithelium without any signs of malignancy. Macroscopically, the surgical specimen contained a submucosal tumor, and histological examination revealed extremely well differentiated adenocarcinoma. Although this type of carcinoma is very rare, it should be considered in the differential diagnosis of esophageal and gastric mucosal lesions.
Yamamoto
Junya
J
First Department of Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Fukuoka, 814-0180, Japan.
Ohshima
Koichi
K
Kohno
Shuzo
S
Ichimiya
Hitoshi
H
Nakagaki
Mituru
M
Yao
Takashi
T
Iwasaki
Hiroshi
H
Ikeda
Seiyo
S
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D002299:Cardia / Q000473:pathology; D002454:Cell Differentiation; D002763:Cholecystectomy; D016145:Endoscopy, Digestive System; D004931:Esophageal Achalasia / Q000175:diagnosis*; D004947:Esophagus / Q000000981:diagnostic imaging; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery