Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2015; 7(8): 118-122
Published online Aug 15, 2015. doi: 10.4251/wjgo.v7.i8.118
Gastric carcinoma originating from the heterotopic submucosal gastric gland treated by laparoscopy and endoscopy cooperative surgery
Taisuke Imamura, Shuhei Komatsu, Daisuke Ichikawa, Hiroki Kobayashi, Mahito Miyamae, Shoji Hirajima, Tsutomu Kawaguchi, Takeshi Kubota, Toshiyuki Kosuga, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Kiyoshi Ogiso, Nobuaki Yagi, Akio Yanagisawa, Takashi Ando, Eigo Otsuji
Taisuke Imamura, Shuhei Komatsu, Daisuke Ichikawa, Hiroki Kobayashi, Mahito Miyamae, Shoji Hirajima, Tsutomu Kawaguchi, Takeshi Kubota, Toshiyuki Kosuga, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Eigo Otsuji, Division of Digestive Surgery, Department of Digestive Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Kiyoshi Ogiso, Nobuaki Yagi, Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Akio Yanagisawa, Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
Takashi Ando, Department of Gastroenterology and Hepatology, Kyoto Kuramaguchi Medical Center, Kyoto 603-8151, Japan
Author contributions: Imamura T and Komatsu S equally contributed to this work; Imamura T, Komatsu S, Ichikawa D, Kobayashi H, Kubota T, Miyamae M, Hirajima S, Kawaguchi T, Kosuga T, Okamoto K, Konishi H, Shiozaki A, Fujiwara H, Ogiso K, Yagi N, Ando T and Otsuji E treated the case; Yanagisawa A performed pathological analyses; Imamura T and Komatsu S collected the data and wrote the manuscript.
Institutional review board statement: This study was institutionally reviewed and comprehensively approved by the Kyoto Prefectural University of Medicine.
Informed consent statement: The patients provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
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: Shuhei Komatsu, MD, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. skomatsu@koto.kpu-m.ac.jp
Telephone: +81-75-2515527 Fax: +81-75-2515522
Received: April 1, 2015
Peer-review started: April 5, 2015
First decision: May 13, 2015
Revised: May 23, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: August 15, 2015
Abstract

Gastric carcinoma is derived from epithelial cells in the gastric mucosa. We reported an extremely rare case of submucosal gastric carcinoma originating from the heterotopic submucosal gastric gland (HSG) that was safely diagnosed by laparoscopy and endoscopy cooperative surgery (LECS). A 66-year-old man underwent gastrointestinal endoscopy, which detected a submucosal tumor (SMT) of 1.5 cm in diameter on the lesser-anterior wall of the upper gastric body. The tumor could not be diagnosed histologically, even by endoscopic ultrasound-guided fine-needle aspiration biopsy. Local resection by LECS was performed to confirm a diagnosis. Pathologically, the tumor was an intra-submucosal well differentiated adenocarcinoma invading 5000 μm into the submucosal layer. The resected tumor had negative lateral and vertical margins. Based on the Japanese treatment guidelines, additional laparoscopic proximal gastrectomy was curatively performed. LECS is a less invasive and safer approach for the diagnosis of SMT, even in submucosal gastric carcinoma originating from the HSG.

Keywords: Heterotopic submucosal gland, Laparoscopy and endoscopy cooperative surgery, Gastric carcinoma, Gastric submucosal tumor, Less invasive treatment

Core tip: This report describes the rare case of a submucosal gastric carcinoma originating from the heterotopic submucosal gastric gland (HSG) that was safely diagnosed by laparoscopy and endoscopy cooperative surgery (LECS). LECS is a less invasive and safer approach for the diagnosis of submucosal tumor, even in submucosal gastric carcinoma originating from the HSG.