Abstract
A 72-years-old male visited our institution because of severe abdominal distention. Abdominal computed tomography revealed liver cirrhosis with massive retention of ascites. Ascites was treated using diuretic drugs and albumin preparation. Gastroendoscopy revealed esophageal varices, which was successfully treated with endoscopic variceal ligation. A follow-up gastroendoscopy performed 4 months later revealed the disappearance of esophageal varices and the presence of a depressed lesion on the anterior wall of the lesser curvature of the midgastric body with a small orifice near the anal side of the depressed lesion, suggesting gastric gland heterotopia. A biopsy from the depressed lesion revealed group 5. Endoscopic ultrasonography revealed anechoic lesions in the third layer and type 0-IIc lesion with invasion to the third layer, suggesting that the IIc lesion invaded thesubmucosal layers. On the basis of endoscopic findings, the IIc lesion was considered to be within the submucosal layer; therefore, Endoscopic Submucosal Dissection (ESD) was performed, and pathological findings of the resected specimen revealed moderately differentiated tubular adenocarcinoma within the mucosallayer and multiple cystic dilated lesions in the submucosal layer. The post-ESD course wasuneventful and recurrence or de novo lesion has not been detected by regular gastroendoscopy
Highlights
Gastric Gland Heterotopia (GGH) is defined as the proliferation of ectopic gastric glands under the submucosal layer
We report a case of early gastric cancer complicated by GGH, which was treated by Endoscopic Submucosal Dissection (ESD)
Follow-up gastroendoscopy performed in June 2011 revealed the disappearance of esophageal varices and the presence of a depressed lesion on the anterior wall of the lesser curvature of the mid-gastric body; he was admitted to our institution for further examination and treatment
Summary
Gastric Gland Heterotopia (GGH) is defined as the proliferation of ectopic gastric glands under the submucosal layer. We report a case of early gastric cancer complicated by GGH, which was treated by ESD. Follow-up gastroendoscopy performed in June 2011 revealed the disappearance of esophageal varices and the presence of a depressed lesion on the anterior wall of the lesser curvature of the mid-gastric body; he was admitted to our institution for further examination and treatment. Further inspection by gastroendoscopy revealed a small orifice near the anal side of the depressed lesion (Figure 1a), which appeared to be gastric gland heterotopia (GGH). Narrow-band imaging (NBI) endoscopy (Figure 1b and 1c) revealed irregular vascular patterns on the surface structures of the depressed lesion, which was consistent with the findings of gastric cancer. Pathological findings of the resected specimen (Figure 2a-2c) revealed moderately differentiated tubular adenocarcinoma within the mucosal layer and multiple cystic dilated lesions in the submucosal layer. Till date recurrence or de novo lesion has not been detected by regular follow-up gastroendoscopy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
