Asai S, Takeshita K, Kano Y, Nakao E, Ichinona T, Fujimoto N, Akamine E, Mori T, Ogawa A. Implantation of esophageal cancer onto post-dissection ulcer after gastric endoscopic submucosal dissection. World J Gastroenterol 2016; 22(9): 2855-2860 [PMID: 26973424 DOI: 10.3748/wjg.v22.i9.2855]
Corresponding Author of This Article
Satoshi Asai, MD, Assistant Director of Endoscopy Center, Department of Gastroenterology, Tane General Hospital, 1-12-21 Kujouminami, Nishi-ku, Osaka 550-0025, Japan. bonyaritetsu1226@hotmail.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
Satoshi Asai, Koutarou Takeshita, Yuki Kano, Eisuke Nakao, Takumi Ichinona, Naoki Fujimoto, Eisuke Akamine, Takuji Mori, Atsuhiro Ogawa, Department of Gastroenterology, Tane General Hospital, Nishi-ku, Osaka 550-0025, Japan
Author contributions: Asai S drafed of the article; Takeshita K, Kano Y were involved in charge of this patient; Nakao E make figures; Ichinona T, and Fujimoto N performed follow-up examination; Akamine E performed ESD for this patient; Mori T made critical revision of the article for important intellectual content; Ogawa A concepted and designed, critical revised the article for important intellectual content, final approval of the article.
Institutional review board statement: The study was reviewed and approved by the Tane General Hospital Institutional Review Board.
Informed consent statement: A study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Authors declare no conflict of interest 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: Satoshi Asai, MD, Assistant Director of Endoscopy Center, Department of Gastroenterology, Tane General Hospital, 1-12-21 Kujouminami, Nishi-ku, Osaka 550-0025, Japan. bonyaritetsu1226@hotmail.co.jp
Telephone: +81-6-65811071 Fax: +81-6-65812520
Received: August 19, 2015 Peer-review started: August 21, 2015 First decision: September 9, 2015 Revised: October 13, 2015 Accepted: December 8, 2015 Article in press: December 8, 2015 Published online: March 7, 2016
Abstract
A case in which implantation of esophageal squamous cell carcinoma onto a post-dissection gastric ulcer was strongly suspected is presented. A 72-year-old man with alcoholic liver cirrhosis underwent esophagogastroduodenoscopy (EGD). Esophageal cancer (EC) (Mt, 20 mm, 0-Is) and gastric cancer (GC) (antrum, 15 mm, 0-IIc) were identified. Biopsy specimens revealed moderately differentiated squamous cell carcinoma (SCC) and differentiated adenocarcinoma, respectively. The GC was resected by endoscopic submucosal dissection (ESD) [14 mm × 9 mm, type 0-IIc, tub1, pT1a(M), ly0, v0, HM(-), VM(-)]. Two months after ESD, radiation therapy was started for the EC, and an almost complete response was obtained. Nine months after the ESD, a follow-up EGD showed a submucosal tumor-like lesion with ulceration, located immediately under the post-ESD scar, and biopsy specimens showed moderately differentiated SCC. There were no similar lesions suggesting hematogenous or lymphatic metastasis in the stomach.
Core tip: A 72-year-old-man had gastric adenocarcinoma and esophageal squamous cell carcinoma (SCC); the gastric cancer was resected by endoscopic submucosal dissection (ESD), and the esophageal cancer was treated by radiation therapy two months after the ESD. The post ESD scar was found to be elevated and ulcerated during follow-up examination nine months after ESD, and the biopsy specimens showed SCC. It was strongly suspected that the lesion was the result of implantation of esophageal cancer onto the post-ESD ulcer, because the tumor was located immediately under the scar, and there were no similar lesions suggesting hematogenous or lymphatic metastasis.
