Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2019; 7(18): 2871-2878
Published online Sep 26, 2019. doi: 10.12998/wjcc.v7.i18.2871
Multiple gastric adenocarcinoma of fundic gland type: A case report
Ou Chen, Ze-Yong Shao, Xiong Qiu, Guang-Ping Zhang
Ou Chen, Ze-Yong Shao, Department of Gastroenterology, Ya’an People’s Hospital, Ya’an 625000, Sichuan Province, China
Guang-Ping Zhang, Department of Pathology, Ya’an People’s Hospital, Ya’an 625000, Sichuan Province, China
Author contributions: Shao ZY and Qiu X are the co-corresponding authors; Chen O contributed to study conception, data collection, and manuscript writing; Zhang GP collected the data; Shao ZY and Qiu X were responsible for case report design and valuable suggestions.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
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/
Corresponding author: Ze-Yong Shao, MD, Associate Chief Physician, Department of Gastroenterology, Ya’an People’s Hospital, No 358, Chenghou Road, Yucheng District, Ya’an 625000, Sichuan Province, China. 353804619@qq.com
Telephone: +86-15281280415
Received: May 7, 2019
Peer-review started: May 10, 2019
First decision: August 1, 2019
Revised: August 11, 2019
Accepted: August 26, 2019
Article in press: August 26, 2019
Published online: September 26, 2019
Abstract
BACKGROUND

In recent years, there have been reports of a new histological type of gastric cancer, termed gastric adenocarcinoma of the fundic gland (GA-FG). This disease entity presents differentiation towards the fundic gland, especially chief cell-predominant differentiation (GA-FG-CCP). GA-FG-CCP easily invades into the submucosa but rarely shows metastasis. The reports mostly describe primarily single lesions. Herein, we report a case with multiple lesions, and summarize the clinicopathologic characteristics of multiple cases.

CASE SUMMARY

A 55-year-old woman underwent upper gastrointestinal endoscopy screening. Two whitish lesions on the anterior wall of the gastric corpus and the gastric fundus were detected. The patient had previously received Helicobacter pylori eradication therapy. The mucosa was characterized as grade C-2 atrophic gastritis. We diagnosed the patient with multiple GA-FG (GA-FG-CCP) by hematoxylin and eosin (HE) staining and immunohistochemical staining of the endoscopic biopsy. Upon performing endoscopic submucosal dissection (ESD), one lesion was not found, but the scar from the biopsy was visible; the mucularis mucosa of the biopsy and ESD-resected specimen were intact. The two lesions showed no lymphatic nor venous invasion. The resection performed appeared to be relatively curative.

CONCLUSION

Cases of multiple GA-FG-CCP are very rare in clinical practice. Most of its clinicopathologic characteristics are similar to those of a single lesion. Our case provides diagnostic and therapeutic information about GA-FG-CCP with multiple lesions.

Keywords: Gastric adenocarcinoma of the fundic gland, Multiple lesions, Pepsinogen-I, Endoscopic submucosal dissection, Case report

Core tip: Multiple gastric adenocarcinoma of the fundic gland (chief cell-predominant type, GA-FG-CCP) is rare in clinical practice. Our case provides diagnostic and therapeutic information about multiple GA-FG-CCP. We also summarize characteristics of three multiple cases with GA-FG-CCP, and most of its endoscopic and clinicopathological features are similar to those of single lesions. More data are needed to advance our understanding.