Successful Endoscopic Submucosal Dissection of Early Gastric Cancer in a Patient after Azacitidine Therapy for the Treatment of Myelodysplastic Syndrome

A 76‒year‒old man was introduced to our hospital after being suspected of having early gastric cancer with an upper gastrointestinal endoscope that was performed to find the cause of anemia. Two cancers were revealed: type 0‒Ⅱa+Ⅰ lesion in the lesser curvature of the upper body and type 0‒Ⅱa+Ⅱc lesion in the greater curvature of the middle body. The blood test showed abnormalities(hemoglobin, 6.8 g/dL; platelets, 26,000/μg). Thus, myelodysplastic syndrome(MDS) was suspected, and since this was prioritized over gastric cancer, the patient was transferred to the hematology department. As high risk MDS was diagnosed, azacitidine therapy was initiated. After 2 cycles of treatment, the blood abnormalities improved(hemoglobin, 11.3 g/dL; platelets, 254,000/μg). ESD was performed in our department for the 2 lesions. Histopathological examination showed that both lesions represented well‒differentiated adenocarcinoma, and so radical resection was performed. Since MDS occurs due to aging and is common among patients, we believe that timely treatment is necessary.