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KMID : 1038120190520040369
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Clinical Endoscopy
2019 Volume.52 No. 4 p.369 ~ p.372
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A Rare Case of Lymph Node Metastasis from Early Gastric Cancer
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Yoshikawa Takaaki
Kadokawa Yoshio
Ohana Masaya
Fukuda Akihisa
Seno Hiroshi
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Abstract
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Gastric cancers that fulfill the Japanese criteria for curative endoscopic resection show a low risk of lymph node (LN) metastasis. Here, we report a case of LN metastasis from early gastric cancer that fulfilled the curative criteria. A 74-year-old Japanese woman was referred to our hospital for treatment of early gastric cancer identified at the site of a hyperplastic polyp that had been diagnosed 10 years prior to presentation. Contrast-enhanced computed tomography did not show any lymphadenopathy and laparoscopy-assisted distal gastrectomy was performed. Histopathological examination revealed a predominantly moderately differentiated adenocarcinoma that measured 15 mm in size and was confined to the mucosa. However, a single metastatic regional LN was observed. A few cancer cells showed positive staining for alpha-fetoprotein. It should be noted that early gastric cancer can be accompanied by LN metastasis even if it fulfills the criteria for curative endoscopic resection.
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KEYWORD
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Early gastric cancer, Lymph node metastasis, Alpha-fetoproteins, Gastric hyperplastic polyp, Endoscopic resection
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