A case of intramucosal gastric cancer, which was like type 3 advanced cancer by endoscopic findings

A 50 year-old woman visited our hospital because of epigastric pain. Upper GI endoscopy revealed a gastric tumor resembled advanced type 3 gastric cancer. Histological examination of the biopsy specimens revealed poorly differentiated adenocarcinoma with small portion of signet ring cell carcinoma. There was no distant metastases by CT examination, we diagnosed this case as an advanced gastric cancer (T2, N0, M0 cStageIB) , then distal gastrectomy was performed. Pathological study of the resected specimen showed intramucosal gastric cancer (por2 (por2＞sig) , pT1a (M) , ly0, v0, pPM0, pDM0, CY0, pR0, pN0, StageIA) , The accuracy of the diagnosis of the depth of gastric cancer invasion in the undifferentiated adenocarcinoma and the differentiated carcinoma are reported to be about 70% and 90% respectively. EUS is useful for further accurate diagnosis, but sometimes it is difficult to make a correct diagnosis of cancer invasion, in particular in a case with a deep ulcer formation.