Two cases of mucinous adenocarcinoma of the stomach mistaken as submucosal tumor
A 54-year-old woman underwent endoscopy at local clinic for symptoms of dyspepsia, vomiting, and poor oral intake. Because endoscopic findings suggested a gastric SMT, the patient was referred to our hospital. The biopsy sample obtained from the lesion at the other clinic was not diagnosed histologically as malignant, and repeat endoscopy at our hospital showed two round, large protruding masses in the antrum with partial obstruction, but without a mucosal abnormality (). Endoscopic ultrasonography (EUS) revealed two large cystic lesions with nonhomogenous mixed echoic masses in the proper muscle layer, without nearby lymph node enlargement (). Computed tomography (CT) also depicted the lesions observed by EUS (). No repeat biopsy was taken. Based on these findings, a gastric SMT was diagnosed, and laparoscopy-assisted antrectomy without lymph node dissection was performed. A protuberant lesions, 4.5 × 3.5 cm in size, was found in the antrum. Microscopic examination revealed the cancer tissue was predominantly located in the submucosal and proper muscle layers (). The pathologic diagnosis was mucinous adenocarcinoma and the lesion was found to have invaded the subserosa, and no lymph node was excised (). Thus, the disease was stages as T3Nx. Although additional surgery was recommended, this was rejected by the patient, and no follow-up was made.