This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Gastrointestinal/ Upper Foregut  • Surgical Oncology  • Diagnosis  • Alert me on articles by topic

Arch Surg. 2008;143(3):312.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Answer: Gastric Juvenile Polyposis (GJP) in Germline SMAD4 Mutation Accompanied by Gastric Cancer

Upper gastrointestinal tract endoscopy on admission of the patient revealed a profuse polyposis of the stomach. Histopathologic examination of one of the polyps showed a tubular adenocarcinoma of the stomach, whereas dysplasia was seen in other lesions. Staging was without evidence of lymphogenic or hematogenic metastases. On colonoscopy, no additional polyps were detected, and the areas of prior polypectomy were inconspicuous. The patient underwent DNA analysis, and a germline SMAD4 mutation was found. We subsequently performed a total gastrectomy with D2 lymphadenectomy and Roux-en-Y reconstruction. The postoperative course was uneventful. Histopathologically, multiple juvenile polyps with superficial erosions were found. Intraepithelial neoplasia was observed in some polyps. Moreover, the intraepithelial neoplasia focally invaded a microinvasive well-differentiated adenocarcinoma (intramucosal adenocarcinoma). Resection margins were tumor free, and 15 regional lymph nodes showed no evidence of carcinoma metastasis. At the first follow-up 3 months after surgery, the anemia and hypoproteinemia had resolved and the . . . [Full Text of this Article]

AUTHOR INFORMATION

RELATED ARTICLE

Image of the Month—Quiz Case
Ines Gockel, Torsten Hansen, and Theodor Junginger
Arch Surg. 2008;143(3):311.
EXTRACT | FULL TEXT