Undiagnosed Borrmann type II gastric cancer due to necrosis and regenerative epithelium.

World J Gastroenterol

Joon Hur, Jae Hyuck Chang, Hoon Young Ko, Jong Hwan Lee, Soo Jeong Kim, Mi Ae Song, Tae Ho Kim, Chang Whan Kim, Sok Won Han, Division of Gastroenterology, Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Bucheon 420-717, South Korea.

Published: July 2014

Endoscopic biopsy is essential to the proper diagnosis and treatment of gastric cancer. Unfortunately, the results of endoscopic biopsy are not always the same as what is expected based on gross endoscopic findings. The results of endoscopic biopsy can be negative for malignancy in Borrmann type IV advanced gastric cancer (AGCa) or gastric lymphoma. However, in the case of type II AGCa, repeated biopsies negative for malignancy have not been reported. A 49-year-old male patient underwent esophagogastroduodenoscopy three times due to large gastric ulcer suspected to be Borrmann type II cancer. However, three repeat endoscopic biopsies with multiple specimens showed necrosis and superficial regenerative epithelium without malignant findings. The patient underwent laparoscopic distal gastrectomy with D2 lymph node dissection. The surgical specimen revealed that the mucosal layer was completely replaced with regenerative epithelium without cancer cells.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110598PMC
http://dx.doi.org/10.3748/wjg.v20.i28.9621DOI Listing

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