Risk of multiple early gastric cancers in a patient with precursor lesions and endoscopic surveillance for 7 years

Abstract

Rationale: 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). Patient concerns: A 62-year-old Chinese female was diagnosed with 5 multiple EGCs or high-grade dysplasia (HGD) with endoscopic surveillance for 7 years. Diagnoses: Synchronous and metachronous multiple EGCs. Interventions: 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. Outcomes: After endoscopy resection, no residual, recurrent, or synchronous lesions were detected by endoscopic surveillance after ESD. Lessons: 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.

Short Telomere Lesions with Dysplastic Metaplasia Histology May Represent Precancerous Lesions of Helicobacter pylori-Positive Gastric Mucosa

“…These findings are not highly specific and may require further diagnostic techniques for more accurate diagnosis. Magnifying endoscopy with narrow band imaging (ME-NBI) enables detailed observation of mucosal surface patterns and microvessel running patterns, and it is useful for the diagnosis of early gastric cancer [ 43 ]. We expect that the application of ME-NBI is likely to be useful in the diagnosis of high-grade DM in the future.…”