Submucosal Tumor-like Early-stage Mucinous Gastric Carcinoma: A Case Study

Chan Hui Yoo; Seun Ja Park; Moo In Park; Won Moon; Hyung Hun Kim; Jun Sik Lee; Jun Young Song; Hee Kyung Jang

doi:10.4166/kjg.2013.62.2.122

Journal List > Korean J Gastroenterol > v.62(2) > 1007126

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Yoo, Park, Park, Moon, Kim, Lee, Song, and Jang: Submucosal Tumor-like Early-stage Mucinous Gastric Carcinoma: A Case Study

Case Report

Korean J Gastroenterol 2013;62(2):122-125.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.62.2.122

Submucosal Tumor-like Early-stage Mucinous Gastric Carcinoma: A Case Study

Chan Hui Yoo, Seun Ja Park, Moo In Park, Won Moon, Hyung Hun Kim, Jun Sik Lee, Jun Young Song, Hee Kyung Jang¹

Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea

¹Department of Pathology, Kosin University College of Medicine, Busan, Korea

Correspondence to: Seun Ja Park, Department of Internal Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 602-702, Korea. Tel: +82-51-990-5205, Fax: +82-51-990-3005, E-mail: parksj6406@daum.net

Received 14 January 2013 Accepted 1 February 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Mucinous gastric carcinoma (MGC) is an unusual histologic subtype, and early detection of MGC is very rare. Early-stage MGC appears as an elevated lesion resembling a submucosal tumor (SMT) due to abundant mucin pools in the submucosa or mucosa. We report a rare case of SMT-like early-stage MGC. Tumor type was predicted preoperatively based on characteristic endoscopic findings, in which an SMT-like mass was observed at the gastric fundus. The tumor was covered by nearly normal mucosa, but with an opening allowing for the passage of copious mucus discharge. A total gastrectomy with Roux-en-Y esophagojejunostomy was subsequently performed. Histopathology of the tumor revealed early-stage (lamina propria) mucinous adenocarcinoma.

Keywords: Stomach, Neoplasms, Mucins

References

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Fig. 1.

Esophagogastroduodenoscopy showed a submucosal tumor-like mass at the gastric fundus. The mass was covered by nearly normal mucosa, with an opening allowing for the passage of copious mucus discharge.

Fig. 2.

Radial endoscopic ultrasound findings. A 26×23 mm round, elevated, heterogenous and hyperechoic mass with multiple anechoic cystic spaces was observed. The lesion did not invade into the submucosal layer.

Fig. 3.

Contrast-enhanced abdominal CT scan revealed a 25×23 mm polypoid intraluminal mass with heterogenous enhancement and partial mucosal irregularity at the gastric fundus.

Fig. 4.

Gross findings. (A) A well-demarcated fungating mass was present in the gastric fundus, measuring 25×23×20 mm in size. (B) In cross-sections of the tissue, the tumor was found to be confined to the mucosa and contained a large amount mucinous material.

Fig. 5.

Microscopic findings (H&E). (A) Well-differentiated mucinous gastric carcinoma with mucin pools lining the tubular adenocarcinomatous epithelium (×40). (B) Mucinous gastric carcinoma confined to the mucosa was characterized by extracellular mucin in the lamina propria (×40).

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