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显示快速复发和进展的胃癌:一例具有成肠细胞分化的胃腺癌

Gastric Cancer Showing Rapid Recurrence and Progression: A Case of Gastric Adenocarcinoma With Enteroblastic Differentiation.

作者信息

Choi Yonghoon

机构信息

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Korean J Helicobacter Up Gastrointest Res. 2024 Mar;24(1):86-90. doi: 10.7704/kjhugr.2024.0007. Epub 2024 Mar 8.

Abstract

Gastric adenocarcinoma with enteroblastic differentiation (GAED) is rare and its clinicopathological characteristics are not well documented. However, reports indicate that it exhibits more aggressive characteristics, including lymph node metastasis or liver metastasis, than a conventional gastric adenocarcinoma. Herein, we report a case of GAED with rapid recurrence and disease progression. A 55-year-old male, diagnosed with gastric cancer (GC), demonstrated initial endoscopic findings suggestive of advanced GC. He underwent curative resection since there was no evidence of lymph node or distant metastases. The disease was reported as an early GC that was confined to the submucosal layer, without evidence of lymph node metastasis in the final pathological results. However, six months after surgery, multiple hepatic metastases were found during abdominal computed tomography; the pathological results were consistent with metastasis from the GC. Immunohistochemistry of the primary carcinoma pathological specimens showed positive results for alpha-fetoprotein and sal-like protein 4, suggesting enteroblastic differentiation, which is thought to be associated with rapid recurrence and disease progression.

摘要

具有成肠细胞分化的胃腺癌(GAED)较为罕见,其临床病理特征尚无充分记录。然而,报告显示,与传统胃腺癌相比,它表现出更具侵袭性的特征,包括淋巴结转移或肝转移。在此,我们报告一例GAED伴快速复发和疾病进展的病例。一名55岁男性,被诊断为胃癌(GC),最初的内镜检查结果提示为进展期GC。由于没有淋巴结或远处转移的证据,他接受了根治性切除术。最终病理结果显示该疾病为局限于黏膜下层的早期GC,无淋巴结转移。然而,术后六个月,腹部计算机断层扫描发现多处肝转移;病理结果与GC转移一致。原发性癌病理标本的免疫组化显示甲胎蛋白和SALL样蛋白4呈阳性结果,提示成肠细胞分化,这被认为与快速复发和疾病进展有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb77/11967714/b6e5d04ee0e9/kjhugr-2024-0007f1.jpg

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