title: Extremely well differentiated adenocarcinoma of the stomach diagnosed preoperatively as esophageal achalasia: report of a case.
abstract: 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.
authors.affiliation: First Department of Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Fukuoka, 814-0180, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohshima
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kohno
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ichimiya
authors.forename: Mituru
authors.initials: M
authors.lastname: Nakagaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Yao
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Seiyo
authors.initials: S
authors.lastname: Ikeda
mesh_terms: 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