Risk of multiple early gastric cancers in a patient with precursor lesions and endoscopic surveillance for 7 years: A case report.Medicine (Baltimore). 2019 May; 98(22):e15686.M
Severe mucosal atrophy or intestinal metaplasia is a risk factor for synchronous and metachronous intestinal gastric cancer. Magnifying endoscopy with narrow-band imaging was useful for assessing differentiated early gastric cancer (EGC).
A 62-year-old Chinese female was diagnosed with 5 multiple EGCs or high-grade dysplasia (HGD) with endoscopic surveillance for 7 years.
Synchronous and metachronous multiple EGCs.
Endoscopic submucosal dissection (ESD) with en bloc resection was performed for all 5 multiple lesions. The ESD specimens were pathologically diagnosed with adenocarcinoma confined to the mucosa or HGD.
After endoscopy resection, no residual, recurrent, or synchronous lesions were detected by endoscopic surveillance after ESD.
Long-term, meticulous endoscopic surveillance is needed to monitor risk factors associated with multiple EGCs in patients with severe mucosal atrophy or intestinal metaplasia despite successful Helicobacter pylori eradication.