A rare case of Helicobacter pylori -uninfected intramucosal poorly differentiated adenocarcinoma that occurred in the ga
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CASE REPORT
A rare case of Helicobacter pylori‑uninfected intramucosal poorly differentiated adenocarcinoma that occurred in the gastric fornix Yukinari Yoshida1 · Hiroaki Takahashi2 · Tomoyuki Ohuchi3 · Satoshi Okahara2 · Yoshifumi Ishii4 · Toshinao Takenouchi3 · Toshiyuki Kubo1 · Takefumi Kikuchi1 · Hiroaki Mita1 · Yasuyo Adachi1 · Norikazu Iwata1 · Masahiro Nakamura1 · Yasushi Adachi1 · Yasuo Kato1 · Takao Endo1 Received: 18 June 2020 / Accepted: 17 September 2020 © Japanese Society of Gastroenterology 2020
Abstract We report a rare case of undifferentiated-type intramucosal gastric cancer that occurred in the fornix of the stomach without Helicobacter pylori infection, which consisted mainly of poorly differentiated adenocarcinoma. A 49-year-old man visited our hospital for a follow-up endoscopic examination of a small depressed lesion of the gastric fornix detected by surveillance esophagogastroduodenoscopy. On magnifying endoscopy with blue laser imaging, the depressed lesion (approximately 10 mm in diameter) was regarded as undifferentiated-type early gastric cancer that proved to be a poorly differentiated adenocarcinoma by histological examination of biopsied specimens. The cancerous lesion was successfully treated with endoscopic submucosal dissection and microscopically showed an intramucosal cancer that invaded the whole mucosal layer with predominant growth of a poorly differentiated adenocarcinoma component. The patient status was verified as Helicobacter pylori-naïve according to the strict diagnostic criteria, thereby confirming this case as an undifferentiated-type Helicobacter pylori-uninfected gastric cancer. Helicobacter pylori-uninfected intramucosal poorly differentiated adenocarcinoma occurring in the gastric fornix has not been previously reported. Keywords Helicobacter pylori-uninfected · Undifferentiated-type · Early gastric cancer · Gastric fornix · Poorly differentiated adenocarcinoma
Introduction Although Helicobacter pylori (HP)-uninfected gastric cancer (GC) (HPUGC) remains poorly understood, published reports of the rare disease have accumulated over the
* Yukinari Yoshida yoshida‑[email protected] 1
Department of Internal Medicine and Gastroenterology, Sapporo Shirakabadai Hospital, 2‑18 7‑26, Tsukisamu Higashi, Toyohira‑ku, Sapporo, Hokkaido 062‑0052, Japan
2
Department of Gastroenterology, Keiyukai Daini Hospital, Hondori‑13, Shiroishi‑ku, Sapporo, Hokkaido 003‑0027, Japan
3
Department of Pathology, Keiyukai Sapporo Hospital, Hondori‑14, Shiroishi‑ku, Sapporo, Hokkaido 003‑0027, Japan
4
Department of Pathology, Sapporo Shirakabadai Hospital, 2‑18 7‑26, Tsukisamu Higashi, Toyohira‑ku, Sapporo, Hokkaido 062‑0052, Japan
past decade [1–16]. While available data on early lesions are increasing, there remains a lack of information about advanced HPUGCs. As with HP-positive GC (HPPGC), HPUGC is histologically divided into differentiated- and undifferentiated-types. However, there is increasing recognition that there are differences in the histopathologic charac
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