Elghali Mohamed Amine, Ben Abdelkrim Mehdi, Mrabet Soumaya, Aloui Emna, Letaief Amal, Krifa Marwa, Mraidha Mohamed Hedi, Belaid Imtinene
Department of Surgery, Farhat Hached University Hopistal, Sousse, Tunisia.
Université de Sousse- Faculté de Medicine de, Sousse, Tunisia.
Ann Med Surg (Lond). 2022 Jun 17;79:104014. doi: 10.1016/j.amsu.2022.104014. eCollection 2022 Jul.
Sarcomatoid carcinoma of the stomach is a very rare type of malignant gastric tumor characterized by distinct cell morphology.Only six cases have been reported in the literature. We report a case which illustrates the great rapidity of evolution and the aggressiveness of this histological type.
A 80-year-old patient was explored for loss of 20 kg and epigastralgia. The explorations showed a non-metastatic antral sarcomatoid carcinoma with celiac necrotic lymphe node. The oncologic comitee decision was surgery straight away without perioperative chemotherapy.4 weeks after his first CT scan the patient was admitted for preparation for surgery. Clinical and morphological examination showed a clear increase in tumor size with associated tumor infection.The patient had distal gastrectomy. The tumor was perforated and locally advanced.The final pathological exams confirmed the histological type. Surgery was R0, but 4 months after surgery, local recurrence compressing gastro intestinal anastomosis was occurred.
Operative difficulties and rapid recurrence after surgery would have been avoided by faster surgery after diagnosis. However, the surgery time was only 1 month, which illustrates the rapid evolution of sarcomatoid tumors.
Sarcomatoid carcinoma is a rare tumor. These tumors can be aggressive with a large tumoral voulume and high rate of locoregional lymph node involvement. Our case illustrate the aggressiveness of this tumor. The benefit of peri-operative treatment is unknown.
胃肉瘤样癌是一种非常罕见的恶性胃肿瘤，具有独特的细胞形态。文献中仅报道过6例。我们报告1例病例，该病例显示了这种组织学类型的快速进展和侵袭性。
一名80岁患者因体重减轻20公斤和上腹部疼痛而接受检查。检查发现为非转移性胃窦肉瘤样癌，伴有腹腔坏死淋巴结。肿瘤学委员会决定立即进行手术，不进行围手术期化疗。在他第一次CT扫描4周后，患者入院准备手术。临床和形态学检查显示肿瘤大小明显增加，并伴有肿瘤感染。患者接受了远端胃切除术。肿瘤已穿孔且局部进展。最终病理检查证实了组织学类型。手术切缘为R0，但术后4个月，发生了局部复发，压迫胃肠吻合口。
诊断后更快地进行手术本可避免手术困难和术后快速复发。然而手术时间仅为1个月，这说明了肉瘤样肿瘤的快速进展。
肉瘤样癌是一种罕见肿瘤。这些肿瘤可能具有侵袭性，肿瘤体积大，局部区域淋巴结受累率高。我们的病例说明了这种肿瘤的侵袭性。围手术期治疗的益处尚不清楚。
