A small early carcinoma of the stomach with extra-perigastric lymph node metastasis: a case report

An early gastric carcinoma, measuring 1.7 X 0.6 cm, had already metastasized to the extra-perigastric lymph node in a 71 year old symptom-free man. Radiographic and endoscopic studies showed a small depressed lesion on the lesser curvature of the antrum and histology of the biopsied specimen revealed a well differentiated adenocarcinoma. Under the diagnosis of IIc type intramucosal carcinoma, partial gastrectomy and wide lymph node dissection was performed. Pathologic study of the resected specimen showed that the cancer cells had invaded the submucosa at an area via a lymphatic vessel and that only one lymph node along the common hepatic artery was involved.