Use of endoscopic submucosal dissection in a patient with synchronous and metachronous gastric cancers secondary to MSH2-related Lynch syndrome
An 80-year-old man with MSH2-related Lynch syndrome with multiple previous malignancies received a diagnosis of gastric cancer (A) in the fundus of the stomach with biopsy-proven hepatic metastases. He was treated with radiation therapy and was given pembrolizumab. After 15 months, a follow-up CT scan showed resolution of the liver metastases. Upper endoscopy showed resolution of the original tumor but the development of 2 new 2.5 cm polypoid lesions in the fundus (B, left) and body (B, right) of the stomach.