Amada En, Kawakubo Hirofumi, Matsuda Satoru, Mayanagi Shuhei, Nakamura Rieko, Irino Tomoyuki, Wada Norihito, Mikami Shuji, Kitagawa Yuko
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan.
Division of Diagnostic Pathology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan.
Surg Case Rep. 2021 Apr 2;7(1):80. doi: 10.1186/s40792-021-01149-z.
In Japan, the prevalence of synchronous multiple intramucosal gastric carcinoma is reported to be 5-15%. Here is a case of a synchronous small gastric carcinoma fulfilling the definite indication and curative criteria for endoscopic submucosal dissection with multiple lymph node metastases.
A Japanese woman in her fifties with a history of endoscopic resection for mucosal poorly differentiated adenocarcinoma was evaluated, with the UICC TNM classification stage being cT1aN0M0 cStageIA. She had undergone total gastrectomy with D1 + lymph node dissection. Histopathological examination revealed 16 individual sporadic lesions in the gastric body, with maximum diameter 3 mm and localization in the lamina propria. Twenty-seven nodes were resected, and metastasis of the carcinoma was revealed in 24 nodes.
Undifferentiated intramucosal gastric cancer has a relatively high probability of lymph node metastasis; however, synchronous early lesions are often overlooked. Frequent follow-up examinations may increase the detection of multiple gastric cancers.
在日本，同步性多发胃黏膜内癌的患病率据报道为5%-15%。本文介绍了一例符合内镜下黏膜下剥离术明确指征及治愈标准的同步性小胃癌病例，该病例伴有多发淋巴结转移。
一名五十多岁的日本女性，有黏膜低分化腺癌内镜下切除病史，经评估，国际抗癌联盟（UICC）TNM分期为cT1aN0M0，c期IA。她接受了D1+淋巴结清扫的全胃切除术。组织病理学检查发现胃体有16个散在病灶，最大直径3毫米，位于固有层。切除了27个淋巴结，其中24个发现有癌转移。
未分化胃黏膜内癌有相对较高的淋巴结转移概率；然而，同步性早期病变常被忽视。频繁的随访检查可能会增加多发胃癌的检出率。
