Gastric Cancer of "Crawling Type" Detected by Additional Gastrectomy After Endoscopic Submucosal Resection.

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Gastric Cancer of "Crawling Type" Detected by Additional Gastrectomy After Endoscopic Submucosal Resection.

Anticancer Res. 2018 04;38(4):2335-2338

Authors: Haruta Y, Nakanishi R, Jogo T, Nakashima Y, Saeki H, Oki E, Fujiwara M, Oda Y, Maehara Y

Abstract
"Crawling type" gastric cancer (GC) is known as a rare variant of early GCs, which is difficult to diagnose at an early stage because of low-grade nuclear atypia and a morphology mimicking intestinal metaplasia. This is a case report of a 69-year-old woman who was diagnosed with early-stage gastric cancer. She had endoscopic submucosal resection (ESD) and histologically, both horizontal and vertical margins were negative. Seven months after ESD, a new lesion of the stomach was detected by follow-up gastroscopy. Laparoscopic distal gastrectomy was performed and "crawling type" glands were observed throughout the whole area of the tumor. We should keep this variant in mind, especially when a tumor is superficial depressed or superficial flat type in the middle of the stomach. Careful observation with multiple biopsies of all mucosal layer and a re-biopsy is the key procedure for obtaining the right diagnosis. Endoscopic and histological characteristics should also be reviewed.

PMID: 29599357 [PubMed - indexed for MEDLINE]

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