Published online Oct 14, 2017. doi: 10.3748/wjg.v23.i38.7047
Peer-review started: June 14, 2017
First decision: July 17, 2017
Revised: August 18, 2017
Accepted: September 13, 2017
Article in press: September 13, 2017
Published online: October 14, 2017
Processing time: 124 Days and 19.5 Hours
Herein, we present a case of gastric adenocarcinoma of fundic gland type (GA-FG) spreading to heterotopic gastric glands (HGG) in the submucosa. A 58-year-old man with epigastric pain was referred to our hospital and underwent an esophagogastroduodenoscopy. A Borrmann type II gastric cancer at the antrum and a 10 mm submucosal tumor-like lesion in the lesser curvature of the upper third of the stomach were detected. Histological examination of the biopsy specimens obtained from the submucosal tumor-like lesion suggested a GA-FG. Therefore, endoscopic submucosal dissection was performed as excisional biopsy, and histopathological examination of the resected specimen confirmed a GA-FG and HGG proximal to the GA-FG. Although the GA-FG invaded the submucosal layer slightly, the submucosal lesion of the GA-FG had a poor stromal reaction and was located just above the HGG in the submucosa. Therefore, we finally diagnosed the lesion as a GA-FG invading the submucosal layer by spreading to HGG.
Core tip: A 58-year-old man had a 10mm submucosal tumor-like lesion in the lesser curvature of the upper third of the stomach. Histological examination of the biopsy specimens suggested a gastric adenocarcinoma of fundic gland type (GA-FG), therefore, endoscopic submucosal dissection was performed as excisional biopsy. Histopathological examination of the resected specimen confirmed a GA-FG invading the submucosal layer slightly, and heterotopic gastric glands (HGG) proximal to the GA-FG. A GA-FG spreading to HGG in the submucosa was diagnosed because the submucosal lesion of the GA-FG had a poor stromal reaction and was located just above the HGG.