A Case Report of Multiple Early Gastric Cancer with Submucosal Gastric Gland Heterotopia

Nagato Sato¹⁾²⁾, Hidehiko Kitagami¹⁾²⁾, Kazuyuki Yokoyama¹⁾²⁾, Juniti Ikeda¹⁾, Doumei Sunaga¹⁾, Yorikatu Shinzato¹⁾, Tatukiti Ozawa¹⁾ Hitoshi Ikeda³⁾ and Hiroyuki Katoh²⁾

Department of Surgery, Kitami Red Cross Hospital¹⁾
Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine²⁾
Pathology/Pathophysiology, Division of Pathophysiological Science, Hokkaido University Graduate School of Medicine³⁾

We report a case of multiple early gastric cancer with submucosal gastric gland heterotopia. A 61-year-old man was admitted to the hospital for further examination of the stomach after a group medical checkup. Endoscopic examination revealed a flush borderless lesion on the posterior wall of the upper body of the stomach, and the biopsy findings indicated Group V (moderate differentiated adenocarcinoma). Endoscopic ultrasonography demonstrated diffuse cystic changes in the submucosal layer. The preoperative diagnose was early gastric cancer with submucosal gastric gland heterotopia. We gave the patient a great deal of information about the disease. He definitely wanted a total gastrectomy and it was performed. Histologically, cystically dilated heterotopic glands appeared in the submucosal layer, and a cancerous lesion on the vestibule of the stomach was observed in addition to the cancerous lesion found by endoscopy. Multiple early gastric cancer with submucosal gastric gland heterotopia was definitely diagnosed. Submucosal gastric gland heterotopia is known as a relatively rare disease, but we must treat the disease with great caution because it is often associated with multiple gastric cancer as was the case in this patient.

Key words
submucosal gastric gland heterotopia, multiple gastric cancer

Reprint requests
Nagato Sato Department of Surgery, Yakumo General Hospital
50 Shinonome-cho, Yakumo, 049-3105 JAPAN

Accepted
September 24, 2003

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