本文描述了我院一位60多岁男性患者进行上消化道内窥镜检查的情况。检查发现，患者胃上部（主要病灶）有一30毫米的隆起病变。胃底和胃体区域出现了多个颜色不正常的平坦粘膜病变以及稍微隆起、呈红色的粘膜下肿块状病变（次要病灶）。对多个次要病灶进行了组织病理学检查，发现是胃腺癌基质腺类型（GA-FG）或胃腺癌基质腺-粘膜类型（GA-FGM）。经狭窄带成像放大内窥镜检查，主要病灶被怀疑为GA-FGM。为了治疗和诊断目的，采用内镜下黏膜下剥离术切除了主要病灶。术后病理诊断为GA-FGM，周围还有两个GA-FGM和大于30个GA-FG病灶。考虑进行全胃切除术，但患者拒绝进一步手术治疗。因此，他进行了每年两次的内窥镜和计算机断层扫描随访。术后五年，未观察到肿瘤生长或转移。© 2023年作者独家授权给国际胃癌协会和日本胃癌协会。

A man in his 60 s underwent upper gastrointestinal endoscopy at our hospital, which revealed a 30-mm elevated lesion in the upper stomach (main lesion). There were several discolored, flat mucosal lesions and slightly elevated, reddish, subepithelial mass-like lesions (multiple secondary lesions) in the gastric fornix and body. Histopathological examination of several biopsied secondary lesions revealed gastric adenocarcinoma of fundic-gland type (GA-FG) or gastric adenocarcinoma of fundic gland-mucosa type (GA-FGM). The main lesion was suspected to be GA-FGM on magnifying endoscopy with narrow-band imaging. It was removed using endoscopic submucosal dissection for therapeutic and diagnostic purposes. The histopathological diagnosis of the resected lesion was GA-FGM, which was surrounded by two GA-FGM and > 30 GA-FG lesions. Total gastrectomy was considered; however, the patient declined further surgical treatment. Therefore, he was followed up with biannual endoscopy and computed tomography. At five years postoperatively, no tumor growth or metastasis has been observed.© 2023. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.