Résumé
To evaluate the clinical effects and pathological characteristics of gastric tumors of fundic gland type treated with endoscopic submucosal dissection (ESD), data of 7 patients who treated by ESD and whose postoperative pathology indicated gastric adenocarcinoma of fundic gland type or gastric oxyntic gland adenoma in Endoscopic Center of Beijing Chao-Yang Hospital of Capital Medical University from August 2018 to June 2022 were collected. The clinical characteristics, surgical complications, preoperative and postoperative pathological data and follow-up data were evaluated. The lesions of the 7 patients were all located at gastric fundus, and were treated by ESD successfully. No bleeding, perforation or other complications occurred during and after the operation. Postoperative pathology showed that tumor cells originated from deep mucosa with an invasive growth pattern. Most of tumor surfaces were covered with normal concave epithelium. Tumors infiltrated into submucosa in 4 patients, and submucosa infiltration depth was more than 500 μm (550 μm) in 1 patient. Immunohistochemistry showed that MUC-6 was diffusely positive, indicating that the tumor originated from the main cell source. The expressions of MUC-2, MUC-5AC, CDX-2, CD10, and CgA were negative in all cases. With the mean follow-up time of 21 months, the ulcer healed well after the operation, with no recurrence. Gastric tumors of fundic gland type have relatively unique biological characteristics, and ESD is the preferred treatment. In addition, the histological characteristics can be used to differentiate from other gastric tumors by immunohistochemistry.
Résumé
Oxyntic gland polyp/adenoma is a recently reported rare neoplasm previously called gastric adenocarcinoma of fundic gland type (chief cell predominant type). We report a case of oxyntic gland adenoma curatively treated with endoscopic mucosal resection. On endoscopy, a small, round polypoid lesion was observed in the fundus of the stomach of a 33-year-old man. He underwent endoscopic mucosal resection with a cap for diagnostic and therapeutic purposes, and was diagnosed as having oxyntic gland adenoma with high-grade dysplasia. On immunohistochemical analysis, the tumor was positive for MUC6 and negative for MUC5AC and MUC2. Our case suggests that endoscopic mucosal resection with immunohistochemical analysis might be useful for correctly diagnosing an uncertain lesion suspected as an oxyntic gland adenoma.