J Korean Surg Soc.  2010 Dec;79(Suppl 1):S26-S30. 10.4174/jkss.2010.79.Suppl1.S26.

Gastric Cancer Associated with Gastritis Cystica Profunda in Patients without Previous Gastric Surgery

• Kim JY
• Hur H
• Cho YK
• Han SU

• KMID: 2040548
• DOI: http://doi.org/10.4174/jkss.2010.79.Suppl1.S26

Abstract

Gastritis cystica profunda (GCP) is an uncommom hyperplastic lesion, which is located within the submucosa. GCP may occur several years after previous gastric surgery. In some reported cases, it was a premalignant condition and may lead to carcinoma of the stomach. We report a case of a 54-year-old man with epigastric pain and dyspepsia. He had undergone peritoneal dialysis for end stage renal disease about 13 years prior. An Upper gastrointestinal endoscopy showed elevated lesion at the gastric antrum, looking like an advanced gastric cancer or gastrointestinal stromal tumor. Endoscopic biopsy results were tubular adenoma with low-grade dysplasia. When followed up 9 months later, the lesion had increased in size and symptoms remained. We therefore performed a subtotal gastrectomy. The final biopsy was adenocarcinoma arising in GCP.

Keyword

Gastric cancer; Gastritis cystica profunda; Peritoneal dialysis

MeSH Terms

Adenocarcinoma
Adenoma
Biopsy
Dyspepsia
Endoscopy, Gastrointestinal
Gastrectomy
Gastritis
Gastrointestinal Stromal Tumors
Humans
Kidney Failure, Chronic
Middle Aged
Peritoneal Dialysis
Pyloric Antrum
Stomach
Stomach Neoplasms

Figure

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  Fig. 1 Endoscopic and abdominal CT finding. (A) 10 months before surgery, endoscopic view of 4 cm sized ulcerofungating mass-like lesion is noted on the low body with irregular base. (B) 4 months before surgery, endoscopic view of 4 cm and 3 cm fungating masses are noted. (C) 1 month before surgery, endoscopic view of fungating mass lesion with hyperemic mucosa and partial ulcerative change. (D) 1 month before surgery endoscopic ultrasonography shows that a 5.2×1.8 cm sized well-marginated mixed echoic hard mass lesion arose from 3rd layer. (E) 3 months before surgery, abdominal CT shows gastric wall thickening at gastric antrum (white arrow).

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  Fig. 2 Pathologic finding. (A) Gross finding: The mucosal surface of the whole body shows a dome-shaped elevated lesion, measuring 8.5×6.5 cm. (B) Gross cut section: Yellowish white solid and fibrotic tumor involves the muscle layer and suspicious subserosal layer. (C) Gastritis cystica profunda (white arrow) and gastric carcinoma arises in gastritis cystica profunda (H&E stain, ×25). (D) Well differentiated tubular adenocarcinoma (black arrowhead) with lymphocyte infiltration (white arrowhead) is shown (H&E stain, ×100).

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