Korean Journal of Gastrointestinal Endoscopy 2011;42(2): 90-93.
내시경 점막하 박리술 후 점막 고유층에 재발한 조기위암 1예
이상훈ㆍ정진환ㆍ송준호ㆍ김정호ㆍ정대영ㆍ김진일ㆍ박수헌ㆍ김재광
가톨릭대학교 의과대학 내과학교실
Local Recurrence of EGC after ESD
Sang Hun Lee, M.D., Jin Hwan Jung, M.D., Jun Ho Song, M.D., Jeong Ho Kim, M.D., Dae Young Cheung, M.D., Jin Il Kim, M.D., Soo Heon Park, M.D. and Jae Kwang Kim, M.D.
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
Abstract
Endoscopic mucosal resection is not accepted as an alternative to surgery for treating EGC of the undifferentiated histologic type because of the relatively higher probability of lymph node metastasis with the endoscopic procedure. The recently developed endoscopic submucosal dissection (ESD) techniques have made en-bloc resection of large intramucosal or ulcerated lesions feasible, but the procedure's therapeutic indications are limited to EGC without lymph node metastasis. If we could define a subgroup of patients who have undifferentiated EGC with a low-risk of lymph node metastasis, then the application of ESD would be possible instead of surgery. ESD also allows precise histologic assessment of resected specimens and it may prevent residual disease and local recurrence. We report on a case that poorly differentiated adenocarcinoma was curatively removed by ESD, but cancer recurrence was detected in the lamina propria of the post ESD scar without lymph node metastasis or intraluminal lesions three years after the ESD. (Korean J Gastrointest Endosc 2011;42:90-93)
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