Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Gastric Adenocarcinoma of Fundic Gland Type with Aggressive Transformation and Lymph Node Metastasis: a Case Report

  • Okumura, Yasuhiro (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research) ;
  • Takamatsu, Manabu (Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research) ;
  • Ohashi, Manabu (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research) ;
  • Yamamoto, Yorimasa (Division of Gastroenterology, Showa University Fujigaoka Hospital) ;
  • Yamamoto, Noriko (Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research) ;
  • Kawachi, Hiroshi (Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research) ;
  • Ida, Satoshi (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research) ;
  • Kumagai, Koshi (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research) ;
  • Nunobe, Souya (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research) ;
  • Hiki, Naoki (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research) ;
  • Sano, Takeshi (Department of Gastroenterological Surgery, The Cancer Institute Hospital, Japanese Foundation for Cancer Research)
  • Received : 2018.03.14
  • Accepted : 2018.07.12
  • Published : 2018.12.31
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Abstract

A 55-year-old man visited our hospital for a detailed examination of a gastric submucosal tumor that was first detected 10 years prior. The tumor continued to grow and had developed a depressed area in its center. A histopathological examination of biopsy specimens revealed gastric adenocarcinoma of the fundic gland type (GA-FG). It was diagnosed as T2 based on the invasion depth as determined by white-light endoscopy and endoscopic ultrasonography. A total gastrectomy with lymphadenectomy was performed and a GA-FG in the mucosa and submucosa was confirmed histopathologically. However, there was a gradual transition to an infiltrative tubular adenocarcinoma with poorly differentiated components in the muscular and subserosal layers. Metastasis was identified in a dissected lymph node (LN). This is the first report of a GA-FG progressing to an aggressive cancer with LN metastasis. These findings modify our understanding of the pathophysiology of GA-FG.

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References

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