52-year-old male suffered from unclear epigastric pain. A gastroscopy was performed which revealed flattened gastric folds accompanied by loss of peristalsis. The diameter of the lesion was about 4cm2. Partial resection of the stomach was performed.
- Circumscribed tumor located predominantly in the mucosa. The muscularis mucosae is infiltrated, and the tumor reaches the submucosa.
- Partly, the tumor is composed of glands arranged in a cribriform pattern (intestinal type of Lauren). A second part of the tumor consists of islands of mucin containing strands of epithelial cells (mucinous adenocarcinoma).
- The neighboring gastric mucosa shows focal intestinal metaplasia.
Early gastric cancer is defined as cancer located in the mucosa or the mucosa and submucosa, only. Extensive tissue sampling has to be performed in order not to miss infiltration of the muscularis propria ("sampling error"). Early gastric cancer has an excellent prognosis, with a 5-year survival of 95%. In contrast, infiltration of the muscularis propria in advanced gastric cancer worsens the prognosis; a 5-year survival of 60-80% is reported.
Intestinal metaplasia of the gastric mucosa is associated with an increased risk of developing a carcinoma. However, it is not considered a precancerous lesion. Compare also slideA