Endoscopic submucosal dissection of squamous cell carcinoma in the upper stomach 5 years after chemoradiotherapy for adenocarcinoma

Primary squamous cell carcinoma is rarely observed, with a reported incidence of 0.04–0.07 % of all gastric cancers. An 81-year-old male underwent chemoradiotherapy for type 1 gastric cancer of the posterior wall of the cardiac region in 2005. The tumor disappeared after 1 year of therapy, following...

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Bibliographic Details
Published in:	Clinical journal of gastroenterology Vol. 7; no. 4; pp. 310 - 315
Main Authors:	Sakemi, Ryosuke, So, Suketo, Morimitsu, Yosuke, Imada, Hajime, Ishihara, Hiroshi, Kuhara, Kenjiro, Oku, Yuichiro, Terabe, Hiroya, Kishi, Masahiro, Sasaki, Ei, Sakemi, Miyuki, Shimokobe, Masayuki
Format:	Journal Article
Language:	English
Published:	Tokyo Springer Japan 01-08-2014
Subjects:	Abdominal Surgery Adenocarcinoma - therapy Aged, 80 and over Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Case Report Chemoradiotherapy Colorectal Surgery Dissection Gastric Mucosa - surgery Gastroenterology Gastroscopy Hepatology Humans Male Medicine Medicine & Public Health Neoplasms, Second Primary - surgery Stomach Neoplasms - pathology Stomach Neoplasms - surgery Stomach Neoplasms - therapy Surgical Oncology Time Factors Endoscopic submucosal dissection Squamous cell carcinoma Gastric cancer Squamous metaplasia
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Summary:	Primary squamous cell carcinoma is rarely observed, with a reported incidence of 0.04–0.07 % of all gastric cancers. An 81-year-old male underwent chemoradiotherapy for type 1 gastric cancer of the posterior wall of the cardiac region in 2005. The tumor disappeared after 1 year of therapy, following which an area of white epithelium, approximately 30 mm in diameter and continuous with the esophageal mucosa, became visible. Biopsy of the white epithelium indicated normal squamous epithelium. An elevated lesion was subsequently detected in the area of white epithelium on upper gastrointestinal endoscopy during a follow-up examination 5 years after therapy. As a biopsy of the same site indicated squamous cell carcinoma, we performed endoscopic submucosal dissection. Histopathological examination indicated high-grade fibrosis due to radiotherapy and showed a moderately differentiated squamous cell carcinoma invading the scarred portion. We describe a case where the developmental process of a squamous cell carcinoma was observed using endoscopy, including narrow band imaging with magnification. This carcinoma likely originated from squamous metaplasia that developed after chemoradiotherapy was administered for a gastric cancer.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1865-7257 1865-7265
DOI:	10.1007/s12328-014-0503-5