Gastric adenocarcinoma of fundic gland type is known to originate from the gastric mucosa of the fundic gland region without intestinal metaplasia. It is difficult to detect during endoscopy and diagnose histopathologically. The development of immunohistochemistry has enabled the diagnosis of gastric adenocarcinoma of fundic gland type by gastric phenotype. A 34-year-old man visited us for treatment of a 5 cm-sized low-grade dysplasia in the gastric fundus which was incidentally found during a health check-up endoscopy. Endoscopic submucosal dissection was performed successfully, and the final histopathology showed gastric adenocarcinoma of fundic gland type. Herein, we report a rare case of gastric adenocarcinoma of fundic gland type and its endoscopic and histopathologic findings.
10 December 2020 in The Korean Journal of Helicobacter and Upper Gastrointestinal Research
Glomus tumor is a benign tumor derived from the vascular wall of the arteriovenous anastomosis complex. Glomus tumors in the gastrointestinal tract are rare, especially those in the duodenum. Most gastrointestinal glomus tumors are found incidentally on endoscopy during routine health checkup and sometimes because of bleeding. We experienced a case of duodenal glomus tumor diagnosed after surgical resection of an incidental subepithelial tumor in the duodenum. Herein, we report the characteristic endoscopic ultrasonography, contrast-enhanced CT, and histopathological findings of duodenal glomus tumor.
Background/Objectives: Endoscopic papillectomy (EP) is the preferred treatment for ampullary tumors because it has fewer side effects than surgical removal. This study retrospectively compared a new anchoring EP method (A-EP) with the conventional (C-EP) approach. Methods: Ninety-nine patients who underwent EP at a single medical institution between 2009 and 2021 were retrospectively reviewed. In all patients, the indications for EP were pathological adenoma with <10 mm of biliary invasion and a tumor diameter <30 mm on endoscopic ultrasonography. The exclusion criteria were antiplatelet/anticoagulant use, previous upper GI surgery, or prior biliary/pancreatic endoscopic therapy. One expert endoscopist performed the two types of EPs, A-EP and C-EP. Results: Sixty-two patients underwent A-EP, and 37 underwent C-EP. There were no significant differences in baseline characteristics, such as sex, age, tumor size, and ductal invasion on endoscopic ultrasound. The A-EP group had higher en bloc resection rates (95.2% vs. 78.4%, p = 0.010). Although the difference was not statistically significant, it tended towards fewer incidences of pancreatitis (p = 0.081) and duct stricture (p = 0.081). The recurrence rate was lower in the A-EP group (8.1% vs. 37.8%, p = 0.000). There were no significant differences between the two groups regarding the follow-up period (A-EP vs. C-EP, 725 vs. 1045 days, p = 0.109) or the days of recurrence (A-EP vs. C-EP, 341 vs. 562 days, p = 0.551). Conclusions: A-EP showed better outcomes than C-EP in terms of en bloc resection and recurrence rates, providing evidence for the efficacy of this novel EP method.
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Gastroenterology & Hepatopancreatobiliary Medicine
Gastroenterology & Hepatopancreatobiliary Medicine