Kimura Yasue, Matsuda Hiroyuki, Saeki Hiroshi, Oki Eiji, Morita Masaru, Sugimachi Keishi, Yamashita Yo-ichi, Ikegami Toru, Uchiyama Hideaki, Yoshizumi Tomoharu, Soejima Yuji, Kawanaka Hirofumi, Ikeda Tetsuo, Tsutsui Shinichi, Fujihara Megumu, Mimori Koshi, Watanabe Masayuki, Ishida Teruyoshi, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Pathology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan.
Fukuoka Igaku Zasshi. 2013 Sep;104(9):315-20.
Adenosquamous carcinoma of the stomach is very rare; at present, there are only seven published reports. We report here an eighth case involving a 77-year-old Japanese man who was diagnosed with gastric cancer by upper endoscopy and computed tomography (CT). He underwent laparoscopic-assisted distal gastrectomy for early gastric cancer and the resected specimen was diagnosed as adenosquamous carcinoma limited to the submucosal layer. Only one lymph node metastasis was noted. Seven months later, liver metastasis (3 tumors, 15 mm maximum in diameter) was detected by abdominal CT. He was started on chemotherapy with S-1 and cisplatin (CDDP) and is alive 14 months after surgery. Almost all cases of adenosquamous carcinoma of the stomach are diagnosed in advanced stages and carry a very poor prognosis. Most patients with early adenosquamous carcinoma of the stomach survive for 2 or more years without recurrence, however our patient experienced recurrence 7 months after surgery. Therefore, future treatment for recurrent adenosquamous carcinoma of the stomach should be considered.
胃腺鳞癌非常罕见；目前，仅有七篇已发表的报告。我们在此报告第八例病例，患者为一名77岁的日本男性，通过上消化道内镜检查和计算机断层扫描（CT）被诊断为胃癌。他因早期胃癌接受了腹腔镜辅助远端胃切除术，切除标本被诊断为局限于黏膜下层的腺鳞癌。仅发现一处淋巴结转移。七个月后，腹部CT检测到肝转移（3个肿瘤，最大直径15毫米）。他开始接受S-1和顺铂（CDDP）化疗，术后14个月仍存活。几乎所有胃腺鳞癌病例都是在晚期被诊断出来的，预后非常差。大多数早期胃腺鳞癌患者可存活2年或更长时间且无复发，然而我们的患者在术后7个月就出现了复发。因此，应考虑未来对复发性胃腺鳞癌的治疗。
