title: Implantation of esophageal cancer onto post-dissection ulcer after gastric endoscopic submucosal dissection.
abstract: A case in which implantation of esophageal squamous cell carcinoma onto a post-dissection gastric ulcer was strongly suspected is presented. A 72-year-old man with alcoholic liver cirrhosis underwent esophagogastroduodenoscopy (EGD). Esophageal cancer (EC) (Mt, 20 mm, 0-Is) and gastric cancer (GC) (antrum, 15 mm, 0-IIc) were identified. Biopsy specimens revealed moderately differentiated squamous cell carcinoma (SCC) and differentiated adenocarcinoma, respectively. The GC was resected by endoscopic submucosal dissection (ESD) [14 mm × 9 mm, type 0-IIc, tub1, pT1a(M), ly0, v0, HM(-), VM(-)]. Two months after ESD, radiation therapy was started for the EC, and an almost complete response was obtained. Nine months after the ESD, a follow-up EGD showed a submucosal tumor-like lesion with ulceration, located immediately under the post-ESD scar, and biopsy specimens showed moderately differentiated SCC. There were no similar lesions suggesting hematogenous or lymphatic metastasis in the stomach.
authors.affiliation: Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Asai
authors.affiliation: Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan.
authors.forename: Koutarou
authors.initials: K
authors.lastname: Takeshita
authors.affiliation: Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kano
authors.affiliation: Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Nakao
authors.affiliation: Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Ichinona
authors.affiliation: Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujimoto
authors.affiliation: Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Akamine
authors.affiliation: Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Mori
authors.affiliation: Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan.
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Ogawa
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy; D000069916:Endoscopic Mucosal Resection / Q000009:adverse effects*; D016145:Endoscopy, Digestive System; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D000077277:Esophageal Squamous Cell Carcinoma; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D009366:Neoplasm Seeding; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013276:Stomach Ulcer / Q000209:etiology / Q000473:pathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Endoscopic submucosal dissection; Esophageal cancer; Gastric cancer; Implantation; Post-dissection ulcer