Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2019; 7(19): 3138-3144
Published online Oct 6, 2019. doi: 10.12998/wjcc.v7.i19.3138
Gastric adenocarcinoma mimicking a submucosal tumor: A case report
Xiao-Li Cheng, Hua Liu
Xiao-Li Cheng, Department of Gastroenterology, Qingdao Sanatorium of Shandong Province, Qingdao 266071, Shandong Province, China
Hua Liu, Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Author contributions: Liu H designed the research and performed the EUS and ESD for the patient; Cheng XL wrote the paper; all authors have read and approved the final version to be published.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and 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: Hua Liu, MD, Attending Doctor, Department of Gastroenterology, the Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao 266003, Shandong Province, China. 412030832@qq.com
Telephone: +86-532-89073209 Fax: +86-532-89073009
Received: May 18, 2019
Peer-review started: May 20, 2019
First decision: July 21, 2019
Revised: August 17, 2019
Accepted: August 27, 2019
Article in press: August 27, 2019
Published online: October 6, 2019
Processing time: 135 Days and 4.8 Hours
Abstract
BACKGROUND

Submucosal tumor (SMT)-like early-stage gastric cancer (GC) has rarely been reported. It is difficult to consider the possibility of GC and differentiate it from other submucosal lesions.

CASE SUMMARY

We present the case of a 50-year-old male patient with a 1.6 cm SMT-like flat elevated lesion covered by congested mucosa on the gastric angle. Magnifying endoscopy with narrow-band imaging, endoscopic biopsy, endoscopic ultrasound, and computed tomography were performed for diagnosis. Endoscopic submucosal dissection and gastrectomy with lymph node dissection were performed. The post-resection pathological analysis led to a final diagnosis of GC (Bormann type I, T1bN2M0).

CONCLUSION

GC should be considered when detecting an SMT-like lesion in the stomach.

Keywords: Subepithelial lesion; Early-stage gastric adenocarcinoma; Endoscopic submucosal dissection; Case report

Core tip: Gastric adenocarcinoma showing features of a submucosal tumor is unusual. Preoperative diagnosis is difficult due to the generally deep location of the tumor and non-specific and overlapping features on imaging studies. In this case, esophagogastroduodenoscopy revealed a 1.6 cm type 0-Is lesion covered by congested mucosa on the gastric angle. Endoscopic ultrasound and computed tomography reveal no swollen lymph nodes and the usual biopsy cannot give a definite diagnosis. After endoscopic submucosal dissection and gastrectomy with lymph node dissection, this patient was diagnosed with GC (Bormann type I, T1bN2M0).