Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지
DOI QR코드

DOI QR Code

An Insufficient Preoperative Diagnosis of Borrmann Type 4 Gastric Cancer in Spite of EMR

  • Ahn, Jae-Bong (Department of Surgery, Hanyang University College of Medicine) ;
  • Ha, Tae-Kyung (Department of Surgery, Hanyang University College of Medicine) ;
  • Lee, Hang-Rak (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kwon, Sung-Joon (Department of Surgery, Hanyang University College of Medicine)
  • Received : 2010.09.14
  • Accepted : 2011.01.05
  • Published : 2011.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Borrmann type 4 gastric cancers are notorious for the difficulty of finding cancer cells in the biopsy samples obtained from gastrofiberscopy. It is important to obtain the biopsy results for making surgical decisions. In cases with Borrmann type 4 gastric cancer, even though the radiological findings (such as an upper gastrointestinal series, abdominal computed tomography and positron emission tomography/computed tomography) or the macroscopic findings of a gastrofiberscopy examination imply a high suspicion of cancer, there can be difficulty in getting the definite pathologic results despite multiple biopsies. In these cases, we have performed endoscopic mucosal resection under gastrofiberscopy as an alternative to simple biopsies. Here we report on a case in which no cancer cells were found even in the endoscopic mucosal resection specimen, but the radiologic evidence and clinical findings were highly suspicious for gastric cancer. The patient finally underwent total gastrectomy with lymph node resection, and she was pathologically diagnosed as having stage IV gastric cancer postoperatively.

Keywords

References

  1. Kwon SJ, Lee GJ. Clinicopathologic characteristics of Borrmann type 4 gastric cancer. J Korean Surg Soc 2003;64:127-133.
  2. Yook JH, Oh ST, Kim BS. Clinicopathological analysis of Borrmann type IV gastric cancer. Cancer Res Treat 2005;37:87-91. https://doi.org/10.4143/crt.2005.37.2.87
  3. Ahn JS, Ryu SW, Kim IH, Sohn SS. Clinicopathological analysis of recurrent gastric cancer after curative resection. J Korean Surg Soc 2003;65:210-216.
  4. Kohli Y, Takeda S, Kawai K. Earlier diagnosis of gastric infiltrating carcinoma (scirrhous cancer). J Clin Gastroenterol 1981;3:17-20.
  5. Balthazar EJ, Siegel SE, Megibow AJ, Scholes J, Gordon R. CT in patients with scirrhous carcinoma of the GI tract: imaging findings and value for tumor detection and staging. AJR Am J Roentgenol 1995;165:839-845. https://doi.org/10.2214/ajr.165.4.7676978
  6. Yashiro, M, Chung YS, Sowa M. Role of orthotopic fibroblasts in the development of scirrhous gastric carcinoma. Jpn J Cancer Res 1994;85:883-886. https://doi.org/10.1111/j.1349-7006.1994.tb02963.x
  7. Yoshida K, Kyo E, Tsujino T, Sano T, Niimoto M, Tahara E. Expression of epidermal growth factor, transforming growth factor-alpha and their receptor genes in human gastric carcinoma; implication for autocrine growth. Jpn J Cancer Res 1990;81:43-51. https://doi.org/10.1111/j.1349-7006.1990.tb02505.x
  8. Takahashi S, Kinoshita T, Konishi M, Nakagouri T, Inoue K, Ono M, et al. Phase II study of sequential high-dose methotrexate and fluorouracil combined with doxorubicin as a neoadjuvant chemotherapy for scirrhous gastric cancer. Gastric Cancer 2001;4:192-197. https://doi.org/10.1007/s10120-001-8009-5
  9. Kim DY, Kim HR, Kim YJ, Kim SK. Clinicopathological features of patients with Borrmann type IV gastric carcinoma. ANZ J Surg 2002;72:739-742. https://doi.org/10.1046/j.1445-2197.2002.02523.x
  10. Kitamura K, Beppu R, Anai H, Ikejiri K, Yakabe S, Sugimachi K, et al. Clinicopathologic study of patients with Borrmann type IV gastric carcinoma. J Surg Oncol 1995;58:112-117. https://doi.org/10.1002/jso.2930580208
  11. Hamy A, Letessier E, Bizouarn P, Paineau J, Aillet G, Mirallie E, et al. Study of survival and prognostic factors in patients undergoing resection for gastric linitis plastica: a review of 86 cases. Int Surg 1999;84:337-343.
  12. Ichiyoshi Y, Maehara Y, Tomisaki S, Oiwa H, Sakaguchi Y, Ohno S, et al. Macroscopic intraoperative diagnosis of serosal invasion and clinical outcome of gastric cancer: risk of underestimation. J Surg Oncol 1995;59:255-260. https://doi.org/10.1002/jso.2930590412
  13. Kinoshita T, Konishi M, Nakagohri T, Inoue K, Oda T, Takahashi S, et al. Neoadjuvant chemotherapy with S-1 for scirrhous gastric cancer: a pilot study. Gastric Cancer 2003;6(Suppl 1):40-44.
  14. Green J, Katz S, Phillips G, Bank S, Ilardi C, Hadju E, et al. Percutaneous sonographic needle aspiration biopsy of endoscopically negative gastric carcinoma. Am J Gastroenterol 1988;83:1150-1153.
  15. Bree RL, McGough MF, Schwab RE. CT or US-guided fine needle aspiration biopsy in gastric neoplasms. J Comput Assist Tomogr 1991;15:565-569. https://doi.org/10.1097/00004728-199107000-00007

Cited by

  1. Undiagnosed Borrmann type II gastric cancer due to necrosis and regenerative epithelium vol.20, pp.28, 2011, https://doi.org/10.3748/wjg.v20.i28.9621
  2. Variable Endoscopic Findings and Clinicopathological Characteristics of Borrmann Type 4 Advanced Gastric Cancer vol.15, pp.3, 2011, https://doi.org/10.7704/kjhugr.2015.15.3.166
  3. Borrmann Type 4 Advanced Gastric Cancer: Focus on the Development of Scirrhous Gastric Cancer vol.49, pp.4, 2011, https://doi.org/10.5946/ce.2016.057
  4. A case report of gastric linitis plastica diagnosed by endoscopic ultrasound-guided fine needle aspiration vol.96, pp.50, 2011, https://doi.org/10.1097/md.0000000000008937
  5. Endoscopic ultrasound-guided cutting of holes and deep biopsy for diagnosis of gastric infiltrative tumors and gastrointestinal submucosal tumors using a novel vertical diathermic loop vol.23, pp.15, 2011, https://doi.org/10.3748/wjg.v23.i15.2795
  6. The significance of a nineteenth century definition in the era of genomics: linitis plastica vol.15, pp.None, 2011, https://doi.org/10.1186/s12957-017-1187-3
  7. Endoscopic ultrasound-guided fine-needle aspiration biopsy for diagnosis of gastric linitis plastica with negative malignant endoscopy biopsies vol.16, pp.4, 2011, https://doi.org/10.3892/ol.2018.9258
  8. Phase II Study of Preoperative Intra-Arterial Epirubicin, Etoposide, and Oxaliplatin Combined with Oral S-1 Chemotherapy for the Treatment of Borrmann Type 4 Gastric Cancer vol.20, pp.4, 2011, https://doi.org/10.5230/jgc.2020.20.e40