A case of synchronous intramucosal gastric carcinoma with multiple lymph node metastases

• Published in: Surgical case reports Vol. 7; no. 1; p. 80
• Main Authors: Amada, En, Kawakubo, Hirofumi, Matsuda, Satoru, Mayanagi, Shuhei, Nakamura, Rieko, Irino, Tomoyuki, Wada, Norihito, Mikami, Shuji, Kitagawa, Yuko
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 02.04.2021; Springer Nature B.V; SpringerOpen
• Subjects: Antigens; Biopsy; Case Report; Case reports; Cytokeratin; Dissection; Endoscopy; Family medical history; Gastric cancer; Gastrointestinal surgery; Lymphatic metastasis; Lymphatic system; Medicine; Medicine & Public Health; Metastasis; Multiple primary neoplasms; Stomach neoplasms; Surgery; Tumors; Multiple primary neoplasms; Lymphatic metastasis; Stomach neoplasms
• ISSN: 2198-7793; 2198-7793
• DOI: 10.1186/s40792-021-01149-z

Background In Japan, the prevalence of synchronous multiple intramucosal gastric carcinoma is reported to be 5–15%. Here is a case of a synchronous small gastric carcinoma fulfilling the definite indication and curative criteria for endoscopic submucosal dissection with multiple lymph node metastases. Case presentation A Japanese woman in her fifties with a history of endoscopic resection for mucosal poorly differentiated adenocarcinoma was evaluated, with the UICC TNM classification stage being cT1aN0M0 cStageIA. She had undergone total gastrectomy with D1 + lymph node dissection. Histopathological examination revealed 16 individual sporadic lesions in the gastric body, with maximum diameter 3 mm and localization in the lamina propria. Twenty-seven nodes were resected, and metastasis of the carcinoma was revealed in 24 nodes. Conclusions Undifferentiated intramucosal gastric cancer has a relatively high probability of lymph node metastasis; however, synchronous early lesions are often overlooked. Frequent follow-up examinations may increase the detection of multiple gastric cancers.