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Updated: Nov 10, 2025
Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
A case of synchronous intramucosal gastric carcinoma with multiple lymph node metastases
En Amada1, Hirofumi Kawakubo2, Satoru Matsuda1
1Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, Japan.
Background:
In Japan, the prevalence of synchronous multiple intramucosal gastric carcinoma is reported to be 5-15%. Here is a case of a synchronous small gastric carcinoma fulfilling the definite indication and curative criteria for endoscopic submucosal dissection with multiple lymph node metastases.
Case Presentation:
A Japanese woman in her fifties with a history of endoscopic resection for mucosal poorly differentiated adenocarcinoma was evaluated, with the UICC TNM classification stage being cT1aN0M0 cStageIA. She had undergone total gastrectomy with D1 + lymph node dissection. Histopathological examination revealed 16 individual sporadic lesions in the gastric body, with maximum diameter 3 mm and localization in the lamina propria. Twenty-seven nodes were resected, and metastasis of the carcinoma was revealed in 24 nodes.
Conclusions:
Undifferentiated intramucosal gastric cancer has a relatively high probability of lymph node metastasis; however, synchronous early lesions are often overlooked. Frequent follow-up examinations may increase the detection of multiple gastric cancers.
