Recurrence after endoscopic curative resection of mucosal gastric cancer associated with an adjacent neoplastic precursor lesion

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Abstract

A 69-year-old man underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) at the lesser curvature in the angle of stomach. Histological examination revealed tub1, pM, ly0, v0, pLM(-), pVM(-), and the resection was considered curative. The scar after ESD was followed by esophagogastroduodenoscopy (EGD) and biopsy. Twenty months later, EGD showed an ulcerative lesion in the vicinity of the ESD scar, and histological examination of the biopsy specimen showed adenocarcinoma. A distal gastrectomy with lymph node dissection was then performed. Postoperative pathology showed tub1, pM, pN0, ly0, v0, and Stage 1A. Skip lesions were seen in the specimen resected by ESD, and the histological review confirmed so-called "dysplasia-like atypia" (DLA) between the lesions. It has been reported recently that in DLA, the dysplasia-like change involves only the bases of the pits, without upper pit or surface epithelium involvement, and it is said that the rate of DLA is higher in gastric cancer patients. We speculated that a precancerous lesion close to the resected cancer developed into a local recurrence.

Original languageEnglish
Pages (from-to)213-216
Number of pages4
JournalActa Medica Okayama
Volume70
Issue number3
Publication statusPublished - 2016

Fingerprint

Dissection
Stomach Neoplasms
Digestive System Endoscopy
Recurrence
Biopsy
Cicatrix
Gastrectomy
Lymph Node Excision
Pathology
Stomach
Adenocarcinoma
Epithelium
Endoscopic Mucosal Resection
Neoplasms

Keywords

  • Dysplasia-like atypia
  • Early gastric cancer
  • Endoscopic submucosal dissection
  • Local recurrence

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

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title = "Recurrence after endoscopic curative resection of mucosal gastric cancer associated with an adjacent neoplastic precursor lesion",
abstract = "A 69-year-old man underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) at the lesser curvature in the angle of stomach. Histological examination revealed tub1, pM, ly0, v0, pLM(-), pVM(-), and the resection was considered curative. The scar after ESD was followed by esophagogastroduodenoscopy (EGD) and biopsy. Twenty months later, EGD showed an ulcerative lesion in the vicinity of the ESD scar, and histological examination of the biopsy specimen showed adenocarcinoma. A distal gastrectomy with lymph node dissection was then performed. Postoperative pathology showed tub1, pM, pN0, ly0, v0, and Stage 1A. Skip lesions were seen in the specimen resected by ESD, and the histological review confirmed so-called {"}dysplasia-like atypia{"} (DLA) between the lesions. It has been reported recently that in DLA, the dysplasia-like change involves only the bases of the pits, without upper pit or surface epithelium involvement, and it is said that the rate of DLA is higher in gastric cancer patients. We speculated that a precancerous lesion close to the resected cancer developed into a local recurrence.",
keywords = "Dysplasia-like atypia, Early gastric cancer, Endoscopic submucosal dissection, Local recurrence",
author = "Satoru Kikuchi and Shunsuke Kagawa and Toshiaki Ohara and Tetsushi Kubota and Kazuya Kuwada and Tetsuya Kagawa and Shinji Kuroda and Yasuhiro Shirakawa and Masahiko Nishizaki and Toshiyoshi Fujiwara",
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T1 - Recurrence after endoscopic curative resection of mucosal gastric cancer associated with an adjacent neoplastic precursor lesion

AU - Kikuchi, Satoru

AU - Kagawa, Shunsuke

AU - Ohara, Toshiaki

AU - Kubota, Tetsushi

AU - Kuwada, Kazuya

AU - Kagawa, Tetsuya

AU - Kuroda, Shinji

AU - Shirakawa, Yasuhiro

AU - Nishizaki, Masahiko

AU - Fujiwara, Toshiyoshi

PY - 2016

Y1 - 2016

N2 - A 69-year-old man underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) at the lesser curvature in the angle of stomach. Histological examination revealed tub1, pM, ly0, v0, pLM(-), pVM(-), and the resection was considered curative. The scar after ESD was followed by esophagogastroduodenoscopy (EGD) and biopsy. Twenty months later, EGD showed an ulcerative lesion in the vicinity of the ESD scar, and histological examination of the biopsy specimen showed adenocarcinoma. A distal gastrectomy with lymph node dissection was then performed. Postoperative pathology showed tub1, pM, pN0, ly0, v0, and Stage 1A. Skip lesions were seen in the specimen resected by ESD, and the histological review confirmed so-called "dysplasia-like atypia" (DLA) between the lesions. It has been reported recently that in DLA, the dysplasia-like change involves only the bases of the pits, without upper pit or surface epithelium involvement, and it is said that the rate of DLA is higher in gastric cancer patients. We speculated that a precancerous lesion close to the resected cancer developed into a local recurrence.

AB - A 69-year-old man underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) at the lesser curvature in the angle of stomach. Histological examination revealed tub1, pM, ly0, v0, pLM(-), pVM(-), and the resection was considered curative. The scar after ESD was followed by esophagogastroduodenoscopy (EGD) and biopsy. Twenty months later, EGD showed an ulcerative lesion in the vicinity of the ESD scar, and histological examination of the biopsy specimen showed adenocarcinoma. A distal gastrectomy with lymph node dissection was then performed. Postoperative pathology showed tub1, pM, pN0, ly0, v0, and Stage 1A. Skip lesions were seen in the specimen resected by ESD, and the histological review confirmed so-called "dysplasia-like atypia" (DLA) between the lesions. It has been reported recently that in DLA, the dysplasia-like change involves only the bases of the pits, without upper pit or surface epithelium involvement, and it is said that the rate of DLA is higher in gastric cancer patients. We speculated that a precancerous lesion close to the resected cancer developed into a local recurrence.

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