Implantation of esophageal cancer onto post-dissection ulcer after gastric endoscopic submucosal dissection

A case in which implantation of esophageal squamous cell carcinoma onto a post-dissection gastric ulcer was strongly suspected is presented. A 72-yearold man with alcoholic liver cirrhosis underwent esophagogastroduodenoscopy(EGD). Esophageal cancer(EC)(Mt, 20 mm, 0-Is) and gastric cancer(GC)(antrum...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2016-03, Vol.22 (9), p.2855-2860
Main Authors: Asai, Satoshi, Takeshita, Koutarou, Kano, Yuki, Nakao, Eisuke, Ichinona, Takumi, Fujimoto, Naoki, Akamine, Eisuke, Mori, Takuji, Ogawa, Atsuhiro
Format: Article
Language:English
Subjects:
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Aged
Biopsy
cancer
Endoscopic
cancer
Gastric
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - radiotherapy
Case Report
dissection
Postdissection
Endoscopic Mucosal Resection - adverse effects
Endoscopy, Digestive System
Endosonography
Esophageal Neoplasms - pathology
Esophageal Neoplasms - radiotherapy
Esophageal Squamous Cell Carcinoma
Gastrectomy - adverse effects
Gastrectomy - methods
Humans
Implantation
Esophageal
Male
Neoplasm Seeding
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Stomach Ulcer - etiology
Stomach Ulcer - pathology
submucosal
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
ulcer
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Summary:A case in which implantation of esophageal squamous cell carcinoma onto a post-dissection gastric ulcer was strongly suspected is presented. A 72-yearold man with alcoholic liver cirrhosis underwent esophagogastroduodenoscopy(EGD). Esophageal cancer(EC)(Mt, 20 mm, 0-Is) and gastric cancer(GC)(antrum, 15 mm, 0-Ⅱc) were identified. Biopsy specimens revealed moderately differentiated squamous cell carcinoma(SCC) and differentiated adenocarcinoma, respectively. The GC was resected by endoscopic submucosal dissection(ESD) [14 mm × 9 mm, type 0-Ⅱc, tub1, p T1a(M), ly0, v0, HM(-), VM(-)]. Two months after ESD, radiation therapy was started for the EC, and an almost complete response was obtained. Nine months after the ESD, a follow-up EGD showed a submucosal tumor-like lesion with ulceration, located immediately under the post-ESD scar, and biopsy specimens showed moderately differentiated SCC. There were no similar lesions suggesting hematogenous or lymphatic metastasis in the stomach.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v22.i9.2855