Gastric Adenocarcinoma of the Fundic Gland Type: Clinicopathological Features of Eight Patients Treated With Endoscopic Submucosal Dissection
BACKGROUNDGastric adenocarcinoma of the fundic gland type (GA-FG) has been added to the 2019 edition of the World Health Organization's list of digestive system-associated cancers. This lesion differentiates toward the fundic gland and mostly involves chief cell-predominant differentiation with low-grade cytology. Clinicians and pathologists are still unaware of this rare disease; consequently, some cases are incorrectly diagnosed. This study aimed to investigate the clinicopathological
... of GA-FG using retrospective analyses of endoscopic and pathological findings. CASE SUMMARYEight cases of endoscopic submucosal dissection (ESD) were obtained from our institution. Patient age ranged from 4880 years (mean, 65 years). Some patients were on acid-suppressing medication. Most lesions were located in the upper third (n = 7) and one was in the middle third of the stomach. Six lesions were of the superficial flat type, while two were of the superficial elevated type. Narrow-band imaging using magnifying endoscopy showed irregular microvascular patterns (MVPs) in four cases and regular MVPs in the remaining cases. All lesions were primarily solitary and ~6 mm in diameter (largest, 12 mm). All tumors were localized in the mucosal layer with six cases of invasion into the submucosal layer. Well-formed glands of chief cells were predominant. Tumor cells were positive for pepsinogen-I, MUC6, SYN, and CD56. Lymphatic and vascular infiltration and metastatic and recurrent disease were not observed in any case.CONCLUSIONGA-FG, a well-differentiated adenocarcinoma with mild atypia, can be completely removed using ESD, with a favorable prognosis in patients.