Liu Yi-Yang, Liang Pan, Feng Kai-Xiang, Chen Kui-Sheng, Yue Song-Wei, Ji Jiang, Li Wei-Wei, Zhao Xi-Tong, Gao Jian-Bo
Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Oncol. 2020 Aug 11;10:1611. doi: 10.3389/fonc.2020.01611. eCollection 2020.
Gastric sarcomatoid carcinoma (GSC) is a very rare malignant tumor. The purpose of this study is to describe the clinical, computed tomography (CT), and pathologic features of GSC to increase awareness of this entity.
The CT features and clinical data of five patients with pathologically documented GSC were retrospectively analyzed and compared with the corresponding data of gastric adenocarcinoma and lymphoma.
Among the 5 patients, 4 were male, and 1 was female. The median age was 59 years. Of the 5 cases of GSC, 3 were in the gastric fundus and cardia, 1 was in the gastric body, and 1 was in the gastric fundus. The gastric wall had local thickening in 4 cases and mass formation in 1 case, with stenosis and deformation of the adjacent gastric cavity. The long-axis diameter of the lesions ranged from 1.4 to 10.2 cm (mean, 4.97 cm) and was <10 cm in 4 cases and >10 cm in 1 case. The tumor showed predominantly inhomogeneous density, with radiodensity values ranging from 30 to 53 HU. In addition, ulcers with an irregular base and slightly raised borders were observed in 4 of 5 cases. After an injection of contrast material, heterogeneous ( = 4) or homogeneous ( = 1) enhancement was observed. After contrast medium injection, obvious enhancement was seen in 2 cases, and moderate enhancement was seen in 3 cases; the peak tumor signal was observed in the portal phase. Two of the patients demonstrated evidence of lymph node involvement, and in one patient, the boundary between the lesion and the left lobe of the liver was unclear, with low attenuation in the right lobe of the liver with circular enhancement. The remaining two patients showed no evidence of metastasis.
Although GSC is extremely rare, it should be considered in the differential diagnosis of gastric adenocarcinoma and lymphoma. CT findings, combined with patient age and sex, can provide support for the diagnosis of GSC. However, the final diagnosis must be confirmed with histopathology.
胃肉瘤样癌（GSC）是一种非常罕见的恶性肿瘤。本研究的目的是描述GSC的临床、计算机断层扫描（CT）及病理特征，以提高对该实体的认识。
回顾性分析5例经病理证实的GSC患者的CT特征及临床资料，并与胃腺癌和淋巴瘤的相应数据进行比较。
5例患者中，男性4例，女性1例。中位年龄为59岁。5例GSC中，3例位于胃底和贲门，1例位于胃体，1例位于胃底。4例胃壁有局部增厚，1例有肿块形成，相邻胃腔狭窄变形。病变的长径为1.4至10.2 cm（平均4.97 cm），4例<10 cm，1例>10 cm。肿瘤主要表现为不均匀密度，放射密度值为30至53 HU。此外，5例中有4例观察到基底不规则且边界略隆起的溃疡。注射对比剂后，观察到不均匀强化（4例）或均匀强化（1例）。注射对比剂后，2例可见明显强化，3例可见中度强化；肿瘤信号峰值出现在门静脉期。2例患者有淋巴结受累证据，1例患者病变与肝左叶边界不清，肝右叶呈低密度伴环形强化。其余2例患者无转移证据。
尽管GSC极为罕见，但在胃腺癌和淋巴瘤的鉴别诊断中应予以考虑。CT表现结合患者年龄和性别可为GSC诊断提供支持。然而，最终诊断必须经组织病理学证实。
