title: Extensive 0-IIc (undifferentiated carcinoma) lesion around a gastric adenoma: a case report.
abstract: A 73-year-old woman underwent esophagogastroduodenoscopy (EGD) at a local hospital, which revealed a flat elevated lesion, approximately 15 mm in diameter, in the posterior wall of the lower gastric body. At our hospital, a repeat EGD and biopsy led to a diagnosis of moderately dysplastic adenoma. The patient requested endoscopic submucosal dissection (ESD). Histopathology revealed a gastric adenoma with negativity for tumor at the vertical margin; however, the horizontal margin was positive for cancer with an undifferentiated carcinoma surrounding the adenoma. EGD was repeated, and a discolored area was found around the ESD scar. Biopsy revealed an undifferentiated carcinoma. Laparoscopic distal gastrectomy was performed, and postoperative histopathology also revealed an undifferentiated carcinoma (50 mm in diameter) surrounding the ESD scar; this lesion was an undifferentiated adenocarcinoma that was colocalized with and spread out to surround the original adenoma. This case is important for consideration of the pattern of development and progression of superficial spreading gastric cancer.
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan. holyyou614@yahoo.co.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Horiuchi
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Fujisaki
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ishikawa
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Yoshizawa
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Suganuma
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Kiyohisa
authors.initials: K
authors.lastname: Dan
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Omae
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ishiyama
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hirasawa
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Yorimasa
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tsuchida
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Etsuo
authors.initials: E
authors.lastname: Hoshino
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Igarashi
authors.affiliation: Department of Gastrointestinal Surgery, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiki
authors.affiliation: Department of Gastrointestinal Surgery, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Gastrointestinal Surgery, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Toshifusa
authors.initials: T
authors.lastname: Nakajima
authors.affiliation: Department of Gastroenterology, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
keywords: Adenoma; Gastric cancer; Undifferentiated carcinoma