Kosin Medical Journal

Case report

Gastric cancer with lymphoid stroma mimicking a subepithelial lesion after a 10-year disease-free interval: a case report: Bang Ju Kim, Sung Eun Kim, Seun Ja Park, Moo In Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Myung Hun Lee, Jung Wook Lee, Kyung Won Seo, Hee-Kyung Chang; Kosin Med J. 2025;40(3):233-238. Published online September 23, 2025; DOI: https://doi.org/10.7180/kmj.25.123

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Abstract PDF PubReader ePub: A 74-year-old male patient presented to our hospital for treatment of gastric cancer in 2021. He had previously visited our institution in 2011 for assessment of a gastric subepithelial lesion (SEL), which was discovered incidentally during a health screening esophagogastroduodenoscopy (EGD). Endoscopic ultrasonography and abdominal computed tomography were conducted for evaluation of the gastric SEL, revealing an approximately 1 cm lesion arising from the muscularis propria. The lesion was initially thought to represent a mesenchymal tumor such as leiomyoma or gastrointestinal stromal tumor. Owing to its small size and absence of symptoms, no immediate intervention was undertaken, and the patient underwent regular surveillance only. Follow-up was maintained until 2018 and no notable changes in the gastric SEL were detected. The patient then voluntarily discontinued further follow-up. In 2021, a routine health screening EGD identified changes in the gastric SEL, and histopathological analysis confirmed adenocarcinoma. The patient subsequently underwent radical total gastrectomy utilizing the Roux-en-Y technique, with the final pathological diagnosis being stage I (pT2N0M0) gastric cancer with lymphoid stroma (GCLS). As of April 2025, there has been no evidence of cancer recurrence. This case illustrates a lesion initially diagnosed as SEL that later was identified as GCLS after a 10-year interval. Therefore, during EGD, clinicians should consider the potential for SEL-like gastric cancer if an SEL is observed. This report highlights the importance of close monitoring and a thorough diagnostic evaluation.

Review article

Gastric cancer and metabolic syndrome: Hyeong Ho Jo; Kosin Med J. 2024;39(1):26-34. Published online March 22, 2024; DOI: https://doi.org/10.7180/kmj.24.108

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Gastric cancer (GC), a prevalent disease in Asian countries, presents a substantial global health challenge. The risk factors for GC include Helicobacter pylori infection, diet, smoking, alcohol, and metabolic syndrome (MetS). This review meticulously examines the intricate connections between MetS and GC, focusing on visceral adipocytes, hormonal factors, obesity, and their impact on survival outcomes. Visceral adipocytes, which secrete inflammatory cytokines and hormones, play a pivotal role in influencing cancer development. Hormonal factors demonstrate nuanced associations with specific GC subtypes, underscoring the complexity of their impact. Large-scale studies exploring obesity-related factors reveal sex-specific nuances and underscore the importance of considering overall weight and body composition. Furthermore, the review explores the impact of eradication therapy for H. pylori infection, which is the most significant factor in the onset of GC, on the components of MetS. Additionally, the influence of MetS on postoperative outcomes and survival in GC patients highlights the interplay between therapeutic interventions and lifestyle factors. This comprehensive exploration sheds light on the multifaceted relationship between MetS and GC, providing valuable insights for future research and preventive strategies.

Citations

Citations to this article as recorded by

Chemotherapy for Metastatic Gastric Cancer
Sung Eun Kim, Moo In Park, Myung Hun Lee
The Korean Journal of Gastroenterology.2025; 85(1): 1. CrossRef
Therapeutic Potential of Anti‐Diabetes Drugs and Anti‐Dyslipidemia Drugs to Mitigate Head and Neck Cancer Risk in Metabolic Syndrome
Sujung Yeom, Dong Hoon Lee, Juhyun Song
CNS Neuroscience & Therapeutics.2025;[Epub] CrossRef

Original article

Intraoperative tumor localization using a titanium ring strip in totally laparoscopic distal gastrectomy for middle-third gastric cancer: Jae-Kyun Park, Chang-In Choi, Tae Yong Jeon, Hyuk Jae Jung, Si Hak Lee, Sun Hwi Hwang, Dae-Hwan Kim; Kosin Med J. 2023;38(2):126-133. Published online June 23, 2023; DOI: https://doi.org/10.7180/kmj.23.113

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Background
This study presents a novel technical tip for intraoperative tumor localization and determination of the proximal resection line using a titanium ring strip for totally laparoscopic distal gastrectomy in patients with middle-third gastric cancer and describes the short-term results of its application.
Methods
In total, 42 patients with middle-third gastric cancer who underwent intraoperative tumor localization using a titanium ring strip and determination of the proximal resection line through intraoperative radiography between January 2020 and December 2021 were enrolled in this study. We retrospectively analyzed patients’ prospectively collected clinical, pathological, and surgical data.
Results
Twenty-six men and 16 women with a mean age of 58.3±12.5 years were enrolled. The mean operation time and estimated blood loss were 212.6±43.0 minutes and 122.4±77.6 mL, respectively. The lengths of the proximal and distal resection margin were 2.0±0.4 cm (range, 0.8–3.7 cm) and 10.5±4.1 cm (range, 0.4–20.4 cm), respectively. Roux-en-Y anastomosis was performed in 30 patients, while Billroth II with Braun anastomosis was performed in 12 patients. There were no procedure-related complications, and the mean postoperative hospital stay was 7.2±1.9 days. For all patients, the negative proximal resection margin was confirmed by postoperative pathological examinations.
Conclusions
Intraoperative tumor localization and determination of the proximal resection line using a titanium ring strip is a useful alternative method that can be easily and safely performed. This method is especially useful for patients with middle-third gastric cancer requiring an appropriate proximal resection margin.

Citations

Citations to this article as recorded by

Laparoscopic ultrasound versus intraoperative gastroscopy for tumor localization in laparoscopic gastrectomy: a comparative cohort study
Dipesh Kumar Yadav, Pengwei Wang, Li Ming, Dandan Bao, Yi Huang, Zhangwei Yang, Hanzhang Huang, Sisi Lin, Yiren Hu
BMC Surgery.2025;[Epub] CrossRef

Case reports

Common Hepatic Artery Originating from Left Gastric Artery: A Rare Variant Encountered in Gastric Cancer Surgery: Chang In Choi, Tae Yong Jeon; Kosin Med J. 2018;33(3):463-467. Published online December 31, 2018; DOI: https://doi.org/10.7180/kmj.2018.33.3.463

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The hepatic artery can have numerous variations. However, a common hepatic artery originating from the left gastric artery and the entire hepatic blood supply furnished by the left gastric artery is an extremely rare anomaly. We encountered this anomaly in a patient with advanced gastric cancer. A surgeon should recognize this image appearance and identify the anomaly. Without knowledge of this anomaly and given the strategy for extensive lesser sac dissection generally employed during gastric cancer surgery, a surgeon could easily inadvertently divide this vessel, resulting in critical liver damage. We report a case of common hepatic artery originating from left gastric artery and review of the literatures.

Citations

Citations to this article as recorded by

Replaced common hepatic artery from left gastric artery during pancreatico‐duodenectomy; insight holds the key
Sunita Gupta, Sri Hari Priya Vemulakonda, Spruha Punati, Tara Prasad Tripathy, Ranjan Kumar Patel, Tanmay Dutta, Bramhadatta Pattnaik
ANZ Journal of Surgery.2024; 94(10): 1871. CrossRef

A Case of Retroperitoneal Fibrosis Secondary to Metastatic Stomach Cancer: Jong Chul Kim, Hyun Yul Rhew; The Journal of Kosin Medical College. 1992;8(1):87-92.

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Original article

Relationship of Histologic Types of Early Gastric Cancer and Types of Gastric Dysplasia: Hee Kyung Chang, Man-Ha Hur; The Journal of Kosin Medical College. 1992;8(2):135-156.

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