A Case of Stage IB Gastric Cancer caused Peritoneal Dissemination in 1 Year after Perforation during Endoscopic Submucosal Dissection

Akihiko Morita, Kazuhisa Yabushita, Jun Kimura, Katsunobu Oyama, Itsuro Terada, Seiichi Yamamoto, Masahide Kaji, Kiichi Maeda and Koji Konishi

Department of Surgery, Toyama Prefectural Central Hospital

Though gastric wall perforation can happen as a complication of endoscopic submucosal dissection (ESD), but no report exists, to our knowledge, of peritoneal dissemination caused by perforation during ESD. We report a case of stage IB gastric cancer causing peritoneal dissemination 1 year after perforation during ESD. An 80-year-old man with an abnormality found in a medical examination and diagnosed with gastric cancer was found in endoscopic ultrasonography to have massive tumor invasion to submucosal layer of stomach. ESD was conducted and gastric wall perforation was detected and endoscopically treated with endoclips, followed 1 month later by curative gastrectomy. One year after surgery, he noticed hard spot of abdominal wall diagnosed by computed tomography and biopsy as metastatic tumor. The tumor extended into the abdominal cavity, which contained nodules of all sizes. The diagnosis was peritoneal dissemination of gastric cancer. Six months later, he died of peritonitis carcinomatosis.

Key words
endoscopic submucosal dissection, peritoneal dissemination, perforation

Reprint requests
Akihiko Morita Department of Surgery, Kurobe City Hospital
1108-1 Mikkaichi, Kurobe, 938-8502 JAPAN

Accepted
September 27, 2006

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