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Endoscopic submucosal dissection as excisional biopsy for anorectal malignant melanoma:A case report

World Journal of Clinical Cases 2019年第13期7卷 1652-1659页

作者： Shigeo Manabe Yoshio Boku Michiyo Takeda Fumitaka Usui ikuhiro hirata Shuji Takahashi Department of Gastroenterology Kouseikai Takeda Hospital Kyoto 600-8558 Japan Fujita Clinic 67 Gokiya-cho Oomiya-dori Shichijo-kudaru Shimogyo-ku Kyoto 600-8267 Japan

BACKGROUND Anorectal malignant melanoma(AMM)is a rare disorder with an extremely poor *** there is currently no consensus on the treatment methods for AMM,surgical procedures have been the most common treatment methods used until *** recently encountered a case of AMM that we diagnosed using endoscopic submucosal dissection(ESD).To our knowledge,this is the first case of ESD for AMM,suggesting that ESD can potentially be a diagnostic and treatment method for *** S UMA/MARY A 77-year-old woman visited our hospital with a chief complaint of anal bleeding and a palpable rectal *** revealed a 20-mm protruded lesion in the lower *** obtaining biopsy specimens from the lesion,although a malignant rectal tumor was suspected,a definitive diagnosis was not *** ultrasonography revealed tumor invasion into the submucosal layer but not the muscular ***,we performed an excisional biopsy using *** examination of the ESD-resected specimen revealed tumor cells positive for Human Melanin Black-45,Melan-A,and ***,the tumor cells lacked melanin pigment;thus,a diagnosis of amelanotic AMM was *** the AMM had massively invaded the submucosal layer and both lymphatic and venous invasion were present,we closely monitored the patient without any additional therapy on the basis of her *** months after ESD,local recurrence was detected,and the patient consented to wide local *** USION It is suggested that ESD is a potential diagnostic and treatment method for AMM.

关键词： Endoscopic submucosal dissection Anorectal malignant melanoma Endoscopic mucosal resection Case report

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Gastric adenocarcinoma of fundic gland type spreading to heterotopic gastric glands

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World Journal of Gastroenterology 2017年第38期23卷 7047-7053页

作者： Shigeo Manabe Ken-ichi Mukaisho Takayuki Yasuoka Fumitaka Usui Tatsuzo Matsuyama ikuhiro hirata Yoshio Boku Shuji Takahashi Department of Gastroenterology Kouseikai Takeda Hospital Department of Pathology Shiga University of Medical Science Fujita Clinic

Herein, we present a case of gastric adenocarcinoma of fundic gland type(GA-FG) spreading to heterotopic gastric glands(HGG) in the submucosa. A 58-year-old man with epigastric pain was referred to our hospital and underwent an esophagogastroduodenoscopy. A Borrmann type II gastric cancer at the antrum and a 10 mm submucosal tumor-like lesion in the lesser curvature of the upper third of the stomach were detected. Histological examination of the biopsy specimens obtained from the submucosal tumorlike lesion suggested a GA-FG. Therefore, endoscopic submucosal dissection was performed as excisional biopsy, and histopathological examination of the resected specimen confirmed a GA-FG and HGG proximal to the GA-FG. Although the GA-FG invaded the submucosal layer slightly, the submucosal lesion of the GA-FG had a poor stromal reaction and was located just above the HGG in the submucosa. Therefore, wefinally diagnosed the lesion as a GA-FG invading the submucosal layer by spreading to HGG.

关键词： Gastric adenocarcinoma of fundic gland type Heterotopic gastric glands Endoscopic submucosal dissection Paracancerous lesion Pepsinogen-I H/K-ATPase

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