A Rare Case of Lymph Node Metastasis from Early Gastric Cancer

• Main Authors: Takaaki Yoshikawa (Author), Yoshio Kadokawa (Author), Masaya Ohana (Author), Akihisa Fukuda (Author), Hiroshi Seno (Author)
• Format: Book
• Published: Korean Society of Gastrointestinal Endoscopy, 2019-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2234-2400; 2234-2443; 10.5946/ce.2018.130
• Keywords: Early gastric cancer; Lymph node metastasis; Alpha-fetoproteins; Gastric hyperplastic polyp; Endoscopic resection; Internal medicine; RC31-1245; Diseases of the digestive system. Gastroenterology; RC799-869
• Source: Clinical Endoscopy, Vol 52, Iss 4, Pp 369-372 (2019)

Gastric cancers that fulfill the Japanese criteria for curative endoscopic resection show a low risk of lymph node (LN) metastasis. Here, we report a case of LN metastasis from early gastric cancer that fulfilled the curative criteria. A 74-year-old Japanese woman was referred to our hospital for treatment of early gastric cancer identified at the site of a hyperplastic polyp that had been diagnosed 10 years prior to presentation. Contrast-enhanced computed tomography did not show any lymphadenopathy and laparoscopy-assisted distal gastrectomy was performed. Histopathological examination revealed a predominantly moderately differentiated adenocarcinoma that measured 15 mm in size and was confined to the mucosa. However, a single metastatic regional LN was observed. A few cancer cells showed positive staining for alpha-fetoprotein. It should be noted that early gastric cancer can be accompanied by LN metastasis even if it fulfills the criteria for curative endoscopic resection.