[A Case of Advanced Gastric Cancer Resembling a Submucosal Tumor]

The patient was a woman in her 40s. Because epigastric pain was observed, an upper gastrointestinal endoscopy was performed, which revealed a submucosal tumor-like protrusion with 2 delles, of approximately 5 cm, near the posterior wall of the greater antral curvature. A definitive diagnosis could not be made using conventional biopsy or EUS-FNA;therefore, surgery was performed to facilitate a diagnosis. The tumor was semicircular beyond the pylorus ring, which made local resection difficult. In addition, considering the possibility of malignancy, we performed lymph node dissection(D1+7, 8, 9, and 12a)in addition to a distal gastrectomy. The postoperative diagnosis was pT4aN1M0, pStage ⅢA. The postoperative course was good, and the patient remained alive and well 7 months after surgery. Cancer treatment should always be considered for atypical submucosal tumors that cannot be confirmed pathologically.