'Sleeping' gastric adenocarcinoma – 7- year follow-up of the antral gastric fold removed by endoscopic submucosal dissection: a case report

A 66-year-old patient underwent several endoscopies over the past 7 years due to weight loss and anaemia, but the cause could not be clarified by endoscopic examinations. On all esophagogastroduodenoscopies (EGDS), a pronounced fold in the antrum was described. At the first EGDS in our institution, she was diagnosed with HP gastritis, biopsies of the accentuated fold in the antrum showed no dysplasia and surveillance was not recommended. 5 years later, she underwent two EGDS at an external institution, which showed already described antral fold, biopsies were not taken. Due to the persistence of the symptoms, she was examined at our institution one year later. The EGDS was reppeated due to persistence of symptoms, where an accentuated fold was described in the same anatomical location as 6 years before. The histopathologic findings of biopsies were consisted of low- and high grade dysplasia, early carcinoma could not be ruled out. The CT scan showed no evidence of distant metastases. The lesion was removed by the endoscopic submucosal dissection. The pathohistological findings showed a high grade adenocarcinoma with lymphovascular invasion, the pathologists could not determine the radicality of the resection. Although gastrectomy was indicated, it was not performed due to comorbid conditions. At the control gastroscopy three months after ESD, biopsies of the scar did not confirm a recurrence. The patient is clinically stable with no signs of recurrence half a year after ESD. At follow-up 6 months after ESD she had mild GERD and CT scans are planned [1] [2].

Publication History

Article published online:
27 March 2025

• References

• 1 Gavric A, Hanzel J, Zagar T, Zadnik V, Plut S, Stabuc B.. Survival outcomes and rate of missed upper gastrointestinal cancers at routine endoscopy: a single centre retrospective cohort study. Eur J Gastroenterol Hepatol 2020; 32 (10): 1312-1321
• 2 Conti CB, Agnesi S, Scaravaglio M, Masseria P, Dinelli ME, Oldani M. idr Early Gastric Cancer: Update on Prevention, Diagnosis and Treatment. Int J Environ Res Public Health 2023; 20 (3): 2149