Endoscopic submucosal dissection of early gastric adenocarcinoma of fundic gland type

A 57-year-old woman presented to our department, complaining of abdominal pain for 1 week. Esophagogastroduodenoscopy (EGD) revealed a 0.3 × 0.4 cm, slightly elevated lesion located on the greater curvature of the upper gastric body, classified as type 0-IIa (superficial elevated). Narrow-band imaging (NBI) demonstrated brownish discoloration of the lesion's surface with a branching vascular pattern of dilated capillaries. Histopathological examination of the EGD biopsy revealed a gastric adenocarcinoma of fundic gland type. The observed cancerous lesion was treated via endoscopic submucosal dissection (ESD). Post-ESD histopathology confirmed a gastric adenocarcinoma of fundic gland type (histologic grade E). The tumor measured 2.8 mm in maximum diameter and focally invaded the submucosa, with the deepest invasive front extending 0.4 mm below the muscularis mucosae. Both lateral and vertical resection margins were free of carcinoma.