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

Sahakian Early gastric cancer

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This summary discusses a case of early gastric cancer in a 74-year-old Korean female. The cancer was discovered during an esophagogastroduodenoscopy (EGD) performed for gastric intestinal metaplasia surveillance. A biopsy confirmed it to be adenocarcinoma. However, whole body CT/PET scan did not show any signs of metastasis. Staging was done using EGD and endoscopic ultrasound (EUS), which revealed irregular nodular mucosa at the angularis, with slight thickening of the mucosal layer but no involvement of the submucosa. <br />A repeat biopsy confirmed the diagnosis of moderately differentiated adenocarcinoma with no lymphovascular invasion. The patient was presented with options of total gastrectomy or endoscopic submucosal dissection (ESD) resection and chose to proceed with ESD. <br />The final pathological diagnosis after ESD resection was a well-differentiated intramucosal adenocarcinoma with no invasion or involvement of deep or lateral margins. The patient underwent regular surveillance with follow-up EGD at 3 months, 6 months, and 2 years, all of which showed no signs of recurrence. The patient will continue to be monitored for persistent gastric intestinal metaplasia.

Keywords

early gastric cancer

74-year-old

adenocarcinoma

endoscopic ultrasound

total gastrectomy

endoscopic submucosal dissection

pathological diagnosis

recurrence

surveillance

follow-up EGD