Korean J Gastroenterol.  2015 Mar;65(3):173-176. 10.4166/kjg.2015.65.3.173.

Endoscopic Submucosal Dissection for Early Gastric Cancer in a Patient with Myelodysplastic Syndrome

• Lim EJ
• Sim EH
• Kim BW
• Kim JI
• Kim JS
• Ji JS
• Choi H

• KMID: 2373203
• DOI: http://doi.org/10.4166/kjg.2015.65.3.173

Abstract

Endoscopic submucosal dissection (ESD) has been successfully performed in thrombocytopenic conditions such as in patients with liver cirrhosis but successful ESD for early gastric cancer (EGC) in hematologic diseases has rarely been reported. A 52-year-old male patient, who had previously been diagnosed with myelodysplastic syndrome 2 years ago, was admitted to our hospital for ESD of EGC. ESD was performed successfully in this patient after platelet concentrates transfusion on the day of ESD. ESD might be an option for the treatment of EGC in thrombocytopenia due to hematologic diseases when optimal supportive managements are applied.

Keyword

Stomach neoplasms; Myelodysplastic syndromes; Endoscopy

MeSH Terms

Early Detection of Cancer
Endosonography
Gastric Mucosa/*surgery
Gastroscopy
Humans
Male
Middle Aged
Myelodysplastic Syndromes/complications/*diagnosis/pathology
Stomach Neoplasms/complications/*diagnosis/pathology
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. (A) Initial gastroscopy. An irregularly elevated lesion, which bled easily when touched, is noted at the posterior wall of the antrum. (B) Endoscopic ultrasound. The lesion measured 3.0 cm at the long axis and is limited to the mucosal layer.

• 

  Fig. 2. Endoscopic submucosal dissection procedures. (A) The lesion is marked with an argon plasma laser after the spraying of indigo carmine. (B) The precut is completed with a hook knife. (C) The lesion is com-pletely dissected en bloc. (D) The dissected lesion measured 6.0×4.5 cm.

• 

  Fig. 3. Follow-up gastroscopy eight weeks after endoscopic submucosal dissection. A red ulcer scar is noted at the site of the dissection.

Reference

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