A 93-year-old female underwent curative endoscopic submucosal dissection (ESD) for intramucosal gastric cancer (70 mm in diameter) in the antrum. The lesion showed an irregularly villous structure covered with mucus. En bloc resection was performed. The large resected specimen induced a longitudinal laceration on the right wall of the esophagogastric junction (EGJ) during retrieval. Unavoidably, we segmented the specimen in the stomach to facilitate retrieval. Histopathological evaluation of the specimen revealed well-to-moderately differentiated tubular and papillary adenocarcinoma. A new elevated lesion (15 mm in diameter) was found at the gastric side of the EGJ laceration scar 6 months after the first ESD, necessitating a second resection with ESD. Endoscopic, histopathological, and immunohistochemical features of the new lesion resembled those of the antral lesion. We assessed the new lesion as a recurrence of cancer caused by implantation of tumor cells in the mucosal laceration after ESD.

We experienced recurrence caused by implantation of tumor cells in a mucosal laceration after curative gastric ESD. Endoscopist should be aware of the risk of implantation after gastric ESD.

一名 93 岁的女性因胃窦黏膜内癌（直径 70 毫米）接受了治愈性内镜黏膜下剥离术 (ESD)。病变表现为不规则的绒毛状结构，上面覆盖着粘液。整体进行了切除术。在取回过程中，大的切除标本在食管胃交界处 (EGJ) 的右壁引起纵向撕裂。不可避免地，我们将胃中的标本分段以方便检索。标本的组织病理学评估显示为中度分化的管状腺癌和乳头状腺癌。在第一次 ESD 后 6 个月，在 EGJ 裂伤疤痕的胃侧发现了一个新的升高的病灶（直径 15 mm），需要进行第二次 ESD 切除。新病变的内镜、组织病理学和免疫组化特征与胃窦病变相似。我们将新病变评估为由 ESD 后粘膜撕裂中肿瘤细胞植入引起的癌症复发。

我们经历了治愈性胃 ESD 后肿瘤细胞植入粘膜裂伤引起的复发。内镜医师应了解胃 ESD 后植入的风险。