Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2015; 21(26): 8208-8214
Published online Jul 14, 2015. doi: 10.3748/wjg.v21.i26.8208
Gastric adenocarcinoma of fundic gland type: Five cases treated with endoscopic resection
Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda
Masaki Miyazawa, Mitsuru Matsuda, Masaaki Yano, Yasumasa Hara, Fumitaka Arihara, Yosuke Horita, Koichiro Matsuda, Akito Sakai, Yatsugi Noda, Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama 930-8550, Japan
Author contributions: Miyazawa M designed the study and wrote the manuscript; Matsuda M, Yano M, Hara Y, Arihara F, Horita Y, Matsuda K, Sakai A and Noda Y were involved in editing the manuscript.
Institutional review board statement: This study (case report) does not involve human and/or animal subjects.
Informed consent statement: This study (case report) does not involve human subjects, so no informed consent was provided.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Masaki Miyazawa, MD, Department of Internal Medicine, Toyama Prefectural Central Hospital, 2-2-78 Nishi-Nagae, Toyama City, Toyama 930-8550, Japan. miyacchi_1985@yahoo.co.jp
Telephone: +81-76-4241531 Fax: +81-76-4220667
Received: November 19, 2014
Peer-review started: November 20, 2014
First decision: January 8, 2015
Revised: February 12, 2015
Accepted: April 3, 2015
Article in press: April 3, 2015
Published online: July 14, 2015
Abstract

Recently, a new disease entity termed gastric adenocarcinoma of fundic gland type (GA-FG) was proposed. We treated five cases of GA-FG with endoscopic submucosal dissection. All tumors were small and located in the upper third of the stomach. Four tumors were macroscopically identified as 0-IIa and one was identified as 0-IIb. Narrow-band imaging with magnifying endoscopy showed an irregular microvascular pattern in 2 cases and a regular microvascular pattern in the remainder. All tumors arose from the deep layer of the lamina propria mucosae and showed submucosal invasion. Lymphatic invasion was seen only in one case, while no venous invasion was recognized. All tumors were positive for pepsinogen-I and MUC6 by immunohistochemistry. None showed p53 overexpression, and the labeling index of Ki-67 was low in all cases. All cases have been free from recurrence or metastasis. Herein, we discussed the clinicopathological features of GA-FG in comparison with past reports.

Keywords: Gastric adenocarcinoma of fundic gland type, Pepsinogen-I, Chief cell, Endoscopic diagnosis, Narrow-band imaging with magnifying endoscopy, Endoscopic submucosal dissection

Core tip: Recently, a new disease entity termed gastric adenocarcinoma of fundic gland type (GA-FG) was proposed. We treated five cases that were diagnosed as GA-FG with endoscopic submucosal dissection. GA-FG has characteristic findings in endoscopic and pathological examinations. For accurate and early endoscopic diagnosis of GA-FG, careful endoscopic examination and detailed pathological evaluation are important. Herein, we discussed the clinicopathological features of GA-FG in comparison with past reports.