Li Z, Zhou Q, Lu J, Zhang H, Teng L. Carcinosarcoma of the stomach with alpha-fetoprotein-producing hepatoid adenocarcinoma: an unexpected combination of two rare subtypes of gastric cancer in one tumor.
J Int Med Res 2021;
49:3000605211037422. [PMID:
34407682 PMCID:
PMC8381432 DOI:
10.1177/03000605211037422]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Carcinosarcoma is a rare malignant neoplasm comprising both epithelial and
mesenchymal components. Hepatoid adenocarcinoma (HAC) is another rare type of
cancer. To date, there are only four reported cases of concurrent
carcinosarcomas with HAC across all tumor types, all of which were observed in
uterine tumors. Here, we report an unusual case of gastric carcinosarcoma
associated with alpha-fetoprotein (AFP)-producing HAC in a 76-year-old woman.
Upon admission, the patient had an elevated serum AFP concentration (448 µg/L),
a necrotic polypoid tumor of the central gastric cardia revealed by endoscopy,
and no evidence of distant metastasis indicated by computed tomography (CT).
Owing to malignancy indicated by biopsy, the patient underwent proximal subtotal
gastrectomy. The resected tumor was composed of both an HAC component and a
sarcoma component, microscopically. The sample was positive for AFP, hepatocyte
paraffin (Hep-Par) 1, glypican-3, SALL4, CDX2, cytokeratin (CK) (pan), CK18,
desmin, and vimentin staining immunohistochemically. In summary, the tumor was
diagnosed as carcinosarcoma of the stomach with AFP-producing HAC. To our
knowledge, this is the first report of gastric carcinosarcoma with AFP-producing
HAC in the English literature describing gastric tumors.
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