A Case of Early Gastric Carcinoma with Micropapillary Carcinoma

Yoshihide Asaumi, Mitsuaki Sakatoku, Mami Kaneko, Zensei Nozaki, Taro Yamato, Satoshi Tabata, Kenichi Ietsugu, Kaoru Kiyohara, Hisayuki Nakashima and Shintaro Terahata*

Department of Surgery and Department of Pathology*, Tonami General Hospital

Micropapillary carcinoma is reported to be an aggressive variant of carcinoma afflicting organs including the breast, lung, urinary bladder, and major salivary glands. It is associated with frequent lymph vascular invasion and dismal clinical outcome. A 56-year-old man seen for an abnormality in fluoroscopy and having undergone proximal gastric resection for early gastric carcinoma 5 years earlier was found in endoscopy to have an 0-IIa+IIc lesion at the greater curve of the antrum. Biopsy results indicated moderately differentiated adenocarcinoma. Computed tomography (CT) showed lymph node swelling around the duodenum. We resected the remnant stomach in D2 lymphadenectomy. The carcinoma consisted mainly of well to moderately differentiated adenocarcinoma. The tumor invaded deepest to the slightly submucosal layer (sm1) and showed micropapillary carcinoma in pathology. Metastatic lymph nodes consisted mostly of micropapillary carcinoma. Micropapillary carcinoma may also have higher malignancy potential in gastric cancer.

Key words
early gastric cancer, micropapillary carcinoma, lymph node metastasis

Reprint requests
Yoshihide Asaumi Department of Surgery, Fukui Prefectural Hospital
2-8-1 Yotsui, Fukui, 910-8526 JAPAN

Accepted
April 22, 2009

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