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Aggressive case of early onset gastric cancer; identifying the knowledge gap
  1. Jennifer M Kolb1,
  2. Stephen Leong2,
  3. Lindsey M Westbrook3,
  4. Swati G Patel1
  1. 1Division of Gastroenterology & Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
  2. 2Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
  3. 3Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
  1. Correspondence to Dr Jennifer M Kolb, Division of Gastroenterology & Hepatology, University of Colorado - Anschutz Medical Campus, Aurora, CO 80045, USA; jennifer.m.kolb{at}cuanschutz.edu

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Introduction

A woman aged 30 years was referred for endoscopy for iron deficiency anaemia. Colonoscopy was normal. Upper endoscopy demonstrated multiple small, carpet-like, sessile polyps in the gastric fundus and a larger 4 cm polyp in the body (figure 1). The duodenum was normal without polyps. Endoscopic ultrasound demonstrated a 35×36 mm hypoechoic polypoid lesion arising from the mucosa and invading into the submucosa, but with well-defined borders suggesting lack of invasion into adjacent structures. Endoscopic mucosal resection was performed on a portion of this polyp for histology. Pathology showed a focus of high-grade dysplasia arising in hyperplastic polyp. Her mother and maternal grandmother had gastric cancer, and her sister had gastric polyps and a non-melanoma skin cancer. The patient underwent a laparoscopic total gastrectomy and surgical pathology demonstrated a poorly differentiated adenocarcinoma with 23 negative lymph nodes, stage pT1bN0M0 (figure 2). No adjuvant therapy was recommended, and surveillance CT scan at …

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Footnotes

  • Twitter @jenkolbmd

  • Correction notice This article has been corrected since it published Online First. A typographical error has been corrected in the legend of figure 2.

  • Contributors Drafting the manuscript: JK, critical revision: SL and SP.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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