Department of Pathology, Asahi General Hospital, Chiba 289-2511, Japan.
World J Gastroenterol. 2012 Aug 14;18(30):4064-8. doi: 10.3748/wjg.v18.i30.4064.
Carcinosarcomas are rare, malignant, biphasic tumors simultaneously comprising carcinoma and sarcoma in a single tumor. We present an extremely rare case of gastric carcinosarcoma with an osteoblastic component that drastically changed its shape within 2 mo. A 59-year-old male patient presented to the emergency outpatient unit with a complaint of black stool. Gastrointestinal endoscopy showed an ulcerated mass in the cardia of the lesser curvature of the stomach. Biopsy specimens revealed only adenocarcinoma. Two months later, the ulcerated lesion drastically changed its shape into an exophytic tumor. Total gastrectomy was performed. In the resected specimen, the gastric tumor contained both adenocarcinoma and sarcoma components with lace-like osteoid. The patient died 7 mo after the operation, and an autopsy was performed. In the autopsy, widespread metastases were present in the liver, lung, lymph nodes and peritoneum. In this report, we describe a case of gastric carcinosarcoma and presume its tumorigenesis based on the autopsy findings.
癌肉瘤是一种罕见的恶性、双相性肿瘤,在单个肿瘤中同时包含癌和肉瘤。我们报告了一例极为罕见的胃癌肉瘤病例,其具有成骨细胞成分,在 2 个月内其形状发生了巨大变化。一名 59 岁男性患者因黑便到急诊门诊就诊。胃肠内窥镜检查显示胃小弯的贲门处有一溃疡性肿块。活检标本仅显示腺癌。2 个月后,溃疡性病变急剧变为外生肿瘤。行全胃切除术。在切除的标本中,胃肿瘤同时含有腺癌和肉瘤成分,并有蕾丝状骨样组织。患者术后 7 个月死亡,并进行了尸检。尸检发现肝脏、肺、淋巴结和腹膜广泛转移。在本报告中,我们描述了一例胃癌肉瘤病例,并根据尸检结果推测其肿瘤发生机制。