Early gastric cancer with widespread duodenal invasion within the mucosa

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
Tsutomu NamikawaKazuhiro Hanazaki

Abstract

We report a rare case of early gastric cancer confined to the mucosal layer with extensive duodenal invasion, curatively removed with distal gastrectomy. An 84-year-old Japanese woman was referred to our hospital with gastric cancer. A barium meal examination and esophagogastroduodenoscopy revealed an irregular nodulated lesion measuring 6.5x5.5 cm in the gastric antrum and an aggregation of small nodules in the duodenal bulb. A biopsy specimen showed well-differentiated adenocarcinoma. The patient underwent distal gastrectomy with partial resection of the duodenal region containing the tumor and regional lymph node dissection, with no complication. Histological examination of the resected tissue confirmed well-differentiated adenocarcinoma limited to the mucosal layer and without lymph node metastasis. The cancer extended into the duodenum as far as 38 mm distant from the pyloric ring, and the resected margins were free of cancer cells. Gastric cancer located adjacent to the pyloric ring thus has the potential for duodenal invasion, even when tumor invasion is confined to the mucosal layer. In such cases, care should be taken during examinations to detect duodenal invasion, and the distal surgical margin must be negative given...Continue Reading

References

Mar 10, 2001·Arquivos De Gastroenterologia·A M NogueiraP G Salles
Apr 17, 2002·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Yuichi KasakuraTetsuro Suzuki

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Citations

Nov 20, 2012·Molecular Cancer Research : MCR·Shoumin ZhuWael El-Rifai
Nov 1, 2007·World Journal of Surgical Oncology·Akihisa MatsudaTakashi Tajiri
Aug 14, 2015·World Journal of Gastroenterology : WJG·Tsutomu NamikawaKazuhiro Hanazaki

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