Résumé
Image-enhanced endoscopy (IEE) plays an integral role in endoscopic diagnosis and treatment. IEE enables an early and accurate detection of cancer and characterization of lesions prior to therapeutic decisions. Ideal IEE can serve as an optical or digital chromoscopic endoscopy, as well as an optical biopsy that predicts exact histopathology. Several IEE modalities have recently been developed and are used in the clinical field. The stomach is a challenging organ for imaging because of its complex secretion function and status of Helicobacter pylori infection. Therefore, understanding the current IEE modalities for their clinical applicability in an evidence-based approach is warranted. Along with technology refinements, the new paradigm will be available for the diagnosis of gastric cancer or other conditions in the stomach in the near future.
Résumé
Image-enhanced endoscopy (IEE) plays an integral role in endoscopic diagnosis and treatment. IEE enables an early and accurate detection of cancer and characterization of lesions prior to therapeutic decisions. Ideal IEE can serve as an optical or digital chromoscopic endoscopy, as well as an optical biopsy that predicts exact histopathology. Several IEE modalities have recently been developed and are used in the clinical field. The stomach is a challenging organ for imaging because of its complex secretion function and status of Helicobacter pylori infection. Therefore, understanding the current IEE modalities for their clinical applicability in an evidence-based approach is warranted. Along with technology refinements, the new paradigm will be available for the diagnosis of gastric cancer or other conditions in the stomach in the near future.
Résumé
The therapeutic indication for endoscopic submucosal dissection (ESD) can be expanded to treat small-sized (<2 cm) early gastric cancer (EGC) with undifferentiated histology. Here, we report the case of a 62-year-old woman in whom EGC was initially diagnosed by endoscopy and CT. She subsequently underwent ESD. Histological examination revealed a mixed type adenocarcinoma with poorly differentiated histology confined to the mucosa without ulcer and lymphovascular involvement. Subsequent regular examinations showed no recurrence for 7 years. She complained of fatigue and weight loss on the 7th year of follow-up. Radiologic examination showed multiple bone metastases and the bone biopsy specimen revealed adenocarcinoma resembling the previous EGC.