Introduction: In Vietnam, gastric cancer (GC) ranks 4th in incidence and 3rd in mortality among all cancers. Most of the new GC cases in Vietnam were diagnosed at an advanced stage. Data on early gastric cancer (EGC) in Vietnam is very limited. This study aimed to evaluate the prevalence, endoscopic and histopathological characteristics of EGC among Vietnamese patients.

Methods: This is a retrospective study conducted at the University Medical Center of Ho Chi Minh City, Vietnam from January 2014 to December 2019.  Electronic medical records of patients with EGC were reviewed to collect data regarding age, gender, endoscopic findings of EGC lesions (including location, size, and their type according to the Japanese classification of gastric carcinoma), and histopathological characteristics of these lesions based on the resected gastric specimens.

Results: Among 1666 patients with GC, there were 67 EGC cases, accounting for 4.0%. All of the patients diagnosed with EGC were older than 40 years. The detection rate of EGCs gradually increased during the study period. The EGC lesions were mostly located in the antrum-incisura angularis (73.1%) with a median diameter of 1.0 cm. Regarding macroscopic types, a majority of these lesions were classified as type 0-IIc (31.3%) and type 0-IIa+0-IIc (29.9%). The most common histological type of EGC was adenocarcinoma (82.1%) and poorly differentiated type (40.3%).

Conclusions: EGCs are mainly detected in individuals aged over 40 years. EGC lesions are commonly located in the antrum-incisura angularis and have characteristic features including the macroscopic and histological types.

Introduction: Pediatric gastric adenocarcinoma (GAC) is sporadic with limited relevant data, and gastric adenocarcinoma, which presents as submucosal, has seldom been reported. The clinical presentation and outcome have not yet been thoroughly understood.

Case presentation: Two boys (10 and 14-year-old) were admitted to the hospital with severe malnutrition. Abdominal CT demonstrated the tumor protruding into the stomach, irregular border, and peritoneal metastasis. Gastric biopsies showed pleomorphic cells, variable size, and increased N/C ratio. These cells were arranged into sheet growth patterns, clusters of cells or incomplete tubules with neutrophils infiltrating. The malignant cells showed strong expression of CK, negativity for CD99, NSE, myogenin, CD3, CD20, ALK, and CD30. Both cases were consistent with poorly differentiated gastric adenocarcinomas, diffuse type with lymphovascular invasion.

Discussion and Conclusion: Pediatric GAC presented with a more advanced stage and poor differentiation. However, the clinical presentation is similar to adult GAC. Because of data limitations, the diagnosis and treatment of pediatric GAC remain a significant challenge. GAC should be kept in mind, especially when a submucosal tumor-like lesion appears in the stomach. Additional molecular investigations, including E-cadherin or HER2 testing of the tumor samples, may offer more treatment choices for these patients.