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In this report, we describe a patient presenting with the superficial spreading type of early gastric cancer (EGC) accompanied by cancerous ulcers. Disease progression and treatment outcome are discussed. After symptoms persisted for more than 1 year, the patient underwent total gastrectomy with D2 lymph node dissection. The patient was diagnosed with superficial spreading cancer (SSC), accompanied by an extensive iic lesions. The progression of this patient suggests that the co-occurrence of cancerous ulcers may contribute to EGC development to some extent. As is known, EGC often develops into advanced gastric cancer with time. However, in our case, we observed a process during which partial cancerous changes developed into ssc over 18 months. Superficial spreading cancer should be considered an EGC variant, which may have the ability to spread superficially along the stomach wall without invading the muscularis propria. But we speculate that, if gene expression changes for some reason, the malignant SSC cells may acquire the ability to grow deeply into the stomach wall. Eventually, Borrmann type IV gastric cancer may develop.

Partial Cancerous Changes Eventually Developing into Superficial Spreading Cancer over 18 Months