Intestinal-type gastric adenocarcinoma without Helicobacter pylori infection successfully treated with endoscopic submucosal dissection.
A 67-year-old woman was admitted to our hospital for further examination and for treatment of gastric neoplasia located on the posterior wall of the antrum of the stomach, as revealed by screening esophagogastroduodenoscopy. The patient had no history of Helicobacter pylori (H. pylori) eradication. Her serum H. pylori antibody and urea breath test results were negative, histopathological findings revealed no H. pylori bacteria, and endoscopic findings revealed no chronic gastritis. We performed endoscopic submucosal dissection (ESD). Histological examination of the resected tissues revealed the tumor to be composed of a well-differentiated tubular adenocarcinoma with a tubular-type adenoma confined to the mucosa. This adenocarcinoma exhibited immunohistochemical expression of CD10, MUC2, and Cdx2, but not MUC5AC or MUC6. This is an extremely rare case of H. pylori infection-negative, intestinal-type, differentiated gastric adenocarcinoma revealed by detailed immunohistochemical examination that was treated with ESD. The patient has had no recurrence of adenocarcinoma after ESD.
Department of Gastroenterology, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Satoshi
S
Kotani
Department of Endoscopy, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan. miyaoka@spch.izumo.shimane.jp.
Youichi
Y
Miyaoka
Department of Gastroenterology, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Aya
A
Fujiwara
Department of Gastroenterology, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Kousuke
K
Tsukano
Department of Gastroenterology, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Sayaka
S
Ogawa
Department of Gastroenterology, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Satoshi
S
Yamanouchi
Department of Gastroenterology, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Ryusaku
R
Kusunoki
Department of Endoscopy, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Hirofumi
H
Fujishiro
Department of Gastroenterology, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Naruaki
N
Kohge
Department of Pathology, Shimane Prefectural Central Hospital, 4-1-1 Himebara, Izumo, 693-8555, Shimane, Japan.
Hideyuki
H
Ohnuma
Department of Internal Medicine 2, Shimane University School of Medicine, 89-1 Enya, Izumo, 693-8501, Shimane, Japan.
Yoshikazu
Y
Kinoshita
D000230:Adenocarcinoma / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D000069916:Endoscopic Mucosal Resection / Q000379:methods*; D005260:Female; D005773:Gastroscopy / Q000379:methods; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*
Endoscopic submucosal dissection; Gastric cancer; Helicobacter pylori-negative