Korean J Gastroenterol.  2011 Feb;57(2):120-124. 10.4166/kjg.2011.57.2.120.

A Case of Mucinous Gastric Adenocarcinoma Mimicking Submucosal Tumor

• Kim JH
• Jeon YC
• Lee GW
• Yoon JY
• Pyo JY
• Oh YH
• Han DS
• Sohn JH

• KMID: 1775842
• DOI: http://doi.org/10.4166/kjg.2011.57.2.120

Abstract

A gastric carcinoma with the endoscopic features resembling a submucosal tumor (SMT) is rare, and reportedly accounting for 0.1% to 0.63% of all resected gastric carcinomas in Japan. A diagnosis of a SMT-like gastric carcinoma is often difficult as the tumors are almost entirely covered with normal mucosa. Furthermore mucinous gastric adenocarcinoma is uncommon histologic subtype of gastric cancer. These tumors are detected mostly in an advanced stage and rarely in an early stage. Early mucinous gastric adenocarcinoma is characterized as an elevated lesion resembling SMT due to abundant mucin pools in the submucosa. Here we report one case of SMT-like mucinous gastric adenocarcinoma, diagnosed by the usual endoscopic biopsy and treated with surgery.

Keyword

Submucosal tumor; Adenocarcinoma, Mucinous

MeSH Terms

Adenocarcinoma, Mucinous/*diagnosis/pathology/ultrasonography
Aged
Diagnosis, Differential
Gastric Mucosa/pathology
Gastroscopy
Humans
Male
Stomach Neoplasms/*diagnosis/pathology/ultrasonography
Tomography, X-Ray Computed

Figure

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  Fig. 1. Gastroscopic and endoscopic ultrasonographic findings. (A) They showed elevated lesion with focal erosion and ulcer in the greater curvature of the gastric lower body to antrum. (B) Reticular high echogenic speckeles were observed in the low echogenic tumor.

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  Fig. 2. Abdominal CT findings. They showed well enhanced mass lesion (arrow) with inhomogenous nature in the greater curvature of the gastric lower body to antrum.

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  Fig. 3. Gross findings of the resected stomach. (A) A round bulged-out mass (arrow) was located on the antrum, measuring about 6×5.5 cm in size. The mucosal surface showed nodularity and focal superficial ulceration. (B) On cross section, the tumor infiltrated into the proper muscle and subserosa. It was mostly composed of gelatinous mucin and focal whitish tan thickened mucosal lesion with relatively normal appearing overlying mucosa.

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  Fig. 4. Microscopic findings. (A) Tumor was located under the inctact mucosa (H&E, ×20). (B) The tumor showed focal papillary growth feature and extracellular pools of mucin (H&E, ×40). (C) Irregular clusters of tumor cells were floating freely in mucinous lakes (H&E, ×100).

Reference

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