title: Endoscopic submucosal dissection of squamous cell carcinoma in the upper stomach 5 years after chemoradiotherapy for adenocarcinoma.
abstract: Primary squamous cell carcinoma is rarely observed, with a reported incidence of 0.04-0.07 % of all gastric cancers. An 81-year-old male underwent chemoradiotherapy for type 1 gastric cancer of the posterior wall of the cardiac region in 2005. The tumor disappeared after 1 year of therapy, following which an area of white epithelium, approximately 30 mm in diameter and continuous with the esophageal mucosa, became visible. Biopsy of the white epithelium indicated normal squamous epithelium. An elevated lesion was subsequently detected in the area of white epithelium on upper gastrointestinal endoscopy during a follow-up examination 5 years after therapy. As a biopsy of the same site indicated squamous cell carcinoma, we performed endoscopic submucosal dissection. Histopathological examination indicated high-grade fibrosis due to radiotherapy and showed a moderately differentiated squamous cell carcinoma invading the scarred portion. We describe a case where the developmental process of a squamous cell carcinoma was observed using endoscopy, including narrow band imaging with magnification. This carcinoma likely originated from squamous metaplasia that developed after chemoradiotherapy was administered for a gastric cancer.
authors.affiliation: Department of Gastroenterology, Tobata Kyoritsu Hospital, Sawami 2-5-1 5F, Tobata-ku, Kitakyushu, Fukuoka, 804-0093, Japan, aviaviavisapo-ryo@room.ocn.ne.jp.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Sakemi
authors.forename: Suketo
authors.initials: S
authors.lastname: So
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Morimitsu
authors.forename: Hajime
authors.initials: H
authors.lastname: Imada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishihara
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kuhara
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Oku
authors.forename: Hiroya
authors.initials: H
authors.lastname: Terabe
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kishi
authors.forename: Ei
authors.initials: E
authors.lastname: Sasaki
authors.forename: Miyuki
authors.initials: M
authors.lastname: Sakemi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shimokobe
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D059248:Chemoradiotherapy; D004210:Dissection; D005753:Gastric Mucosa / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D016609:Neoplasms, Second Primary / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D013997:Time Factors