ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (Live and Virtual)

Sahakian Early gastric cancer

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This document discusses a case of early gastric cancer in a 74-year-old Korean female. The patient underwent an esophagogastroduodenoscopy (EGD) for gastric intestinal metaplasia (IM) surveillance, which revealed an area of erosion at the angularis. Biopsy results showed adenocarcinoma, and further staging was performed using EGD and endoscopic ultrasound (EUS). The EUS showed slight thickening of the mucosal layer without involvement of the submucosa (SM). A repeat biopsy confirmed moderately differentiated adenocarcinoma, and the EUS staging was determined to be T1aN0. <br /><br />The patient was presented with the options of total gastrectomy or endoscopic submucosal dissection (ESD) resection and chose to proceed with ESD. Pathological examination of the resected tissue revealed a well-differentiated intramucosal adenocarcinoma with no lymphovascular invasion. The deep and lateral margins were negative for carcinoma and high-grade dysplasia (HGD). <br /><br />Follow-up endoscopies at 3 months, 6 months, and 2 years were negative for recurrence, and the patient will continue surveillance for persistent gastric IM. There were no financial conflicts of interest related to the content provided or referenced in this presentation. The presenter's contact information is provided for further inquiries.

Keywords

early gastric cancer

74-year-old

Korean female

esophagogastroduodenoscopy

gastric intestinal metaplasia

adenocarcinoma

endoscopic ultrasound

T1aN0

total gastrectomy

endoscopic submucosal dissection