[Locally recurrent case of gastric cancer with serosal invasion after four months of endoscopic submucosal dissection].

A 52-year-old woman underwent endoscopic submucosal dissection (ESD) for early gastric cancer at the lesser curvature. Microscopic examination revealed tub1, pSM1, ly0, v0, pHM0, and pVM0, which were considered to be relative resection. Four months later, upper gastrointestinal endoscopy showed local recurrence with suspected SM massive tumor infiltration. We performed a laparoscopic distal gastrectomy with lymph node dissection. Postoperative pathology showed tub2, pT4a (SE), pN2, ly0, v0, and fStage IIIb. This indicated that a few remnant cancer cells were stimulated by the local inflammation associated with ESD. ESD is less invasive than open surgery, but strict observation following curative resection is essential to rule out inflammation-mediated recurrence.