Department of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.
Cancer Center, Gifu University Hospital, 1-1 Yanagido, Gifu City, 501-1194, Japan.
BMC Gastroenterol. 2022 Jul 28;22(1):360. doi: 10.1186/s12876-022-02432-5.
Gastric carcinosarcoma is most frequently diagnosed at an advanced stage when the tumor is generally large with invasion into other organs, lymph node metastasis, and distant metastasis. Standard chemotherapy has not been established, and surgery is the only curative treatment. Here, we present a case of postoperative recurrence of gastric carcinosarcoma under long-term tumor control with pazopanib.
A 77-year-old man was referred to our hospital because of nausea and vomiting. Computed tomography and upper gastrointestinal endoscopy revealed a type 1 tumor arising from the gastric antrum and extending into the duodenal bulb. He underwent distal gastrectomy (D2) with Roux-en-Y reconstruction. Histopathologically, the tumor had mixed adenocarcinoma and sarcoma components. According to the tumor-node-metastasis classification, the diagnosis was primary gastric carcinosarcoma pT1bN1M0 stage IB. Liver metastasis was detected 2 months after surgery; multiple lung metastases were detected 17 month after surgery. A genomic profiling test was performed using liver specimens as the patient became refractory to chemotherapy commonly used for gastric cancer, and the test revealed FGFR2 amplification along with TP53 R209*, AKT3 N127D, NOTCH1 A2036T, and POLD1 M161I. The patient was treated with pazopanib (800 mg/daily), and the tumor growth was controlled for 11 months.
We report a case of postoperative recurrence of gastric carcinosarcoma under long-term tumor control with pazopanib. This case suggested that pazopanib may be effective in treating gastric carcinosarcoma.
胃的癌肉瘤最常被诊断为晚期，此时肿瘤通常较大，伴有向其他器官侵袭、淋巴结转移和远处转移。尚未确立标准的化疗方案，手术是唯一的治愈性治疗方法。在此，我们报告了一例在帕唑帕尼长期肿瘤控制下术后复发的胃癌肉瘤病例。
一名 77 岁男性因恶心和呕吐被转诊至我院。计算机断层扫描和上消化道内镜检查显示胃窦部的 1 型肿瘤，并延伸至十二指肠球部。他接受了远端胃切除术（D2）和 Roux-en-Y 重建。组织病理学上，肿瘤具有混合腺癌和肉瘤成分。根据肿瘤-淋巴结-转移分期，诊断为原发性胃癌肉瘤 pT1bN1M0 期 IB。术后 2 个月发现肝转移；术后 17 个月发现多个肺转移。由于患者对常用于治疗胃癌的化疗产生耐药性，对肝标本进行了基因组分析检测，检测结果显示 FGFR2 扩增，同时伴有 TP53 R209*、AKT3 N127D、NOTCH1 A2036T 和 POLD1 M161I。患者接受了帕唑帕尼（800mg/天）治疗，肿瘤生长得到了 11 个月的控制。
我们报告了一例在帕唑帕尼长期肿瘤控制下术后复发的胃癌肉瘤病例。该病例提示帕唑帕尼可能对胃癌肉瘤有效。
