ABSTRACT
Early gastric cancer(EGC) has been proved to be a malignant tumor with favorable prognosis in contrast to the advanced one, thus early diagnosis has always been the emphasis regardless its type. In particular, diagnosis of superficial flat type EGC(IIb) is extremely difficult on gross inspection. The aim of this study is to review the clinical features of the patients with EGC type IIb, with special reference to the endoscopic appearance of tumor. We reviewed the medical records and endoscopic findings of 13 patients which were thereafter surgically resected and pathologically proven EGC type IIb at SNUH from 1989 to 1993. The depressed lesion was observed most frequently in EGC type IIb. The endoscopic suggestion of EGC type IIb were given initially with mucosal bleeding and discoloration. In 3 cases (20%), tumor extended to the submucosa and in only 1 case, lymph node metastasis was found. Four patients(30.9%) had another coincidental EGC or peptic ulcer. Every possible effort is needed not to omit the resectable cancer when the mucosal bleeding and discoloration is observed. Careful observation is recommended not to overlook coincidental lesions.
Subject(s)
Humans , Diagnosis , Early Diagnosis , Hemorrhage , Lymph Nodes , Medical Records , Neoplasm Metastasis , Peptic Ulcer , Prognosis , Stomach NeoplasmsABSTRACT
The prevalence of colon cancer is increasing in Korea and the principal strategy of its management is early detection and surgical resection. For the early detection of colon cancer, endoscopic evaluation is important and the ability to find out early stage small lesion is needed for the endoscopist. To find out encloscopic features of early colon cancer, we reviewed 17 cases of early colon cancer who have admitted to Seoul National University Hospital from January 1982 to December 1993. 1)59% of the lesions were located in rectum and the size ranged from 0.7cm to 9cm, all of the 17 cases showed polypoid mass contour and the surface of them had erosion, hyperemia, ulceration and easy touch bleeding tendency. 2) Colon cancer was diagnosed by endoscopic gross findings in 41% and endoscopic biopsy could confirm colon cancer in 70%. However, barium enema could diagnose only 41% of early colon cancer. 3) Five cases were operated under the diagnosis of colonic adenoma which were large(>3 cm) villous type or contained severe dysplasia 4) Submucosal tumor infiltration was found in 10 cases and 65% had associated adenoma 5) Lymph node involvement was none and there was no recurrence in 47 month follow up period after various surgical treatments.
Subject(s)
Adenoma , Barium , Biopsy , Colon , Colonic Neoplasms , Diagnosis , Endoscopy , Enema , Follow-Up Studies , Hemorrhage , Hyperemia , Korea , Lymph Nodes , Prevalence , Rectum , Recurrence , Seoul , UlcerABSTRACT
The endoscopic diagnosis of gastric carcinoid has been considered difficult. Reported cases of this tumor diagnosed by endoscopic examination are rare. And the gastric carcinoid with massive upper gastrointestinal bleeding is a rare disease entity. We experienced a case of gastric carcinoid admitted to the hospital because of hematemesis, melena and syncope. And it was diagnosed by endoscopic biopsy, although it resembled type IIa+IIc early gastric cancer at endoscopic examination. To our knowledge, this is the first case report of gastric carcinoid tumor mimicking early gastric cancer. So we report this case with a review of relevant literatures.