Korean J Gastroenterol.  2013 Aug;62(2):122-125. 10.4166/kjg.2013.62.2.122.

Submucosal Tumor-like Early-stage Mucinous Gastric Carcinoma: A Case Study

• Yoo CH
• Park SJ
• Park MI
• Moon W
• Kim HH
• Lee JS
• Song JY
• Jang HK

• KMID: 1775750
• DOI: http://doi.org/10.4166/kjg.2013.62.2.122

Abstract

Mucinous gastric carcinoma (MGC) is an unusual histologic subtype, and early detection of MGC is very rare. Early-stage MGC appears as an elevated lesion resembling a submucosal tumor (SMT) due to abundant mucin pools in the submucosa or mucosa. We report a rare case of SMT-like early-stage MGC. Tumor type was predicted preoperatively based on characteristic endoscopic findings, in which an SMT-like mass was observed at the gastric fundus. The tumor was covered by nearly normal mucosa, but with an opening allowing for the passage of copious mucus discharge. A total gastrectomy with Roux-en-Y esophagojejunostomy was subsequently performed. Histopathology of the tumor revealed early-stage (lamina propria) mucinous adenocarcinoma.

Keyword

Stomach; Neoplasms; Mucins

MeSH Terms

Adenocarcinoma, Mucinous/*diagnosis/pathology/ultrasonography
Adult
Early Detection of Cancer
Endoscopy, Digestive System
Female
Humans
Mucous Membrane/pathology
Neoplasm Staging
Stomach Neoplasms/*diagnosis/pathology/ultrasonography
Tomography, X-Ray Computed

Figure

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  Fig. 1. Esophagogastroduodenoscopy showed a submucosal tumor-like mass at the gastric fundus. The mass was covered by nearly normal mucosa, with an opening allowing for the passage of copious mucus discharge.

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  Fig. 2. Radial endoscopic ultrasound findings. A 26×23 mm round, elevated, heterogenous and hyperechoic mass with multiple anechoic cystic spaces was observed. The lesion did not invade into the submucosal layer.

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  Fig. 3. Contrast-enhanced abdominal CT scan revealed a 25×23 mm polypoid intraluminal mass with heterogenous enhancement and partial mucosal irregularity at the gastric fundus.

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  Fig. 4. Gross findings. (A) A well-demarcated fungating mass was present in the gastric fundus, measuring 25×23×20 mm in size. (B) In cross-sections of the tissue, the tumor was found to be confined to the mucosa and contained a large amount mucinous material.

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  Fig. 5. Microscopic findings (H&E). (A) Well-differentiated mucinous gastric carcinoma with mucin pools lining the tubular adenocarcinomatous epithelium (×40). (B) Mucinous gastric carcinoma confined to the mucosa was characterized by extracellular mucin in the lamina propria (×40).

Reference

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