1
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Shin J, Park YS. Unusual or Uncommon Histology of Gastric Cancer. J Gastric Cancer 2024; 24:69-88. [PMID: 38225767 PMCID: PMC10774758 DOI: 10.5230/jgc.2024.24.e7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 01/17/2024] Open
Abstract
This review comprehensively examines the diverse spectrum of gastric cancers, focusing on unusual or uncommon histology that presents significant diagnostic and therapeutic challenges. While the predominant form, tubular adenocarcinoma, is well-characterized, this review focuses on lesser-known variants, including papillary adenocarcinoma, micropapillary carcinoma, adenosquamous carcinoma, squamous cell carcinoma (SCC), hepatoid adenocarcinoma, gastric choriocarcinoma, gastric carcinoma with lymphoid stroma, carcinosarcoma, gastroblastoma, parietal cell carcinoma, oncocytic adenocarcinoma, Paneth cell carcinoma, gastric adenocarcinoma of the fundic gland type, undifferentiated carcinoma, and extremely well-differentiated adenocarcinoma. Although these diseases have different nomenclatures characterized by distinct histopathological features, these phenotypes often overlap, making it difficult to draw clear boundaries. Furthermore, the number of cases was limited, and the unique histopathological nature and potential pathogenic mechanisms were not well defined. This review highlights the importance of understanding these rare variants for accurate diagnosis, effective treatment planning, and improving patient outcomes. This review emphasizes the need for ongoing research and case studies to enhance our knowledge of these uncommon forms of gastric cancer, which will ultimately contribute to more effective treatments and better prognostic assessments. This review aimed to broaden the pathological narrative by acknowledging and addressing the intricacies of all cancer types, regardless of their rarity, to advance patient care and improve prognosis.
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Affiliation(s)
- Jinho Shin
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Soo Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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2
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Taslim S, Rimin N, James A, Anika NN, Naz J, Shehryar A, Rehman A. A Rare Intersection: A Case of Gastric Adenocarcinoma With Yolk Sac Differentiation. Cureus 2023; 15:e46019. [PMID: 37900463 PMCID: PMC10602405 DOI: 10.7759/cureus.46019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
This case report presents a rare instance of a 73-year-old male diagnosed with a yolk sac tumor (YST) coexisting with adenocarcinoma components in the stomach. YSTs are primarily gonadal and seldom occur in extragonadal sites such as the gastrointestinal tract. The patient underwent curative resection followed by chemotherapy, resulting in long-term survival without recurrence. This case contributes to the limited existing literature on gastric YSTs, emphasizing the importance of early diagnosis and effective treatment for this aggressive malignancy. It serves as a valuable addition to our understanding of the pathophysiology, diagnosis, and management of this rare condition.
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Affiliation(s)
- Sanzida Taslim
- Psychiatry, Ross University School of Medicine, Far Rockaway, USA
| | - Nishat Rimin
- Internal Medicine, Francis Lewis High School, New York, USA
| | - Aimen James
- Dermatology, Rehman Medical Institute, Peshawar, PAK
| | - Nabila N Anika
- Surgery, Baylor College of Medicine, Houston, USA
- Internal Medicine, Holy Family Red Crescent Medical College and Hospital, Dhaka, BGD
| | - Javeria Naz
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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3
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A locally advanced primary gastric adenocarcinoma with a choriocarcinomatous component successfully treated by FLOT chemotherapy and surgery: A Case Report and Literature Review. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2022. [DOI: 10.1016/j.cpccr.2022.100157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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4
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Otani T, Kanemura H, Kimura M, Mitani S, Takeda M, Matsuki M, Matsumura N, Satou T, Nakagawa K, Ito A. Yolk Sac Tumor in a Recurrence of Colonic Adenocarcinoma With Shared Mutations in APC and TP53 Genes: A Case Report. Int J Surg Pathol 2022; 30:646-651. [PMID: 34986057 DOI: 10.1177/10668969211069963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Only four cases of colorectal adenocarcinoma with a yolk sac tumor (YST) component have been reported in the English literature. No genetic investigation has been performed in these cases. We report a case of colorectal adenocarcinoma in which the recurrent tumor had a YST component. A 49-year-old woman presented with a pelvic tumor three years after endoscopic mucosal resection of sigmoid colon adenocarcinoma. The pelvic tumor consisted of an undifferentiated carcinoma component and a YST component. The serum alpha-fetoprotein level was elevated to 42 ng/mL. Treatment as conventional colorectal carcinoma produced some anticancer effects, but the patient died 14 months after the recurrence and 49 months after the EMR. With the help of the next-generation sequencing results of the recurrent tumor, APC c.835 - 8A > G and TP53 c.524G > A (p.R175H) mutations were identified by direct sequencing in both the primary and the recurrent tumors, confirming the relationship between the two metachronous tumors.
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Affiliation(s)
- Tomoyuki Otani
- Kindai University Faculty of Medicine, Osaka-sayama, Japan.,326473Kindai University Hospital, Osaka-sayama, Japan
| | | | | | | | | | | | | | - Takao Satou
- 326473Kindai University Hospital, Osaka-sayama, Japan
| | | | - Akihiko Ito
- Kindai University Faculty of Medicine, Osaka-sayama, Japan
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5
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Whaley RD, Dougherty RE, Cheng L, Ulbright TM. Fluorescence In Situ Hybridization for the X and Y Chromosome Centromeres Helps Differentiate Between Gestational and Nongestational Choriocarcinoma in Clinically Ambiguous Cases. Arch Pathol Lab Med 2021; 144:863-868. [PMID: 31846368 DOI: 10.5858/arpa.2019-0207-oa] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2019] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Gestational choriocarcinoma usually presents during the reproductive years, typically within 1 year of pregnancy, although presentation remote from pregnancy also occurs and may cause confusion with other tumors, including choriocarcinoma of germ cell origin and somatic carcinomas with choriocarcinomatous differentiation. It is important to separate these tumors for treatment and prognostic reasons. OBJECTIVE.— To assess the utility of fluorescence in situ hybridization for the X and Y chromosome centromeres in determining the gestational origin of clinically ambiguous extrauterine choriocarcinomas in women. DESIGN.— A review of female patients with extrauterine choriocarcinomas who had no evidence of prior gestational trophoblastic disease was performed. Samples were analyzed by fluorescence in situ hybridization for the X and Y chromosome centromeres using standard methodologies. RESULTS.— Five cases met the criteria, all of which displayed trophoblastic cells and necrosis. Three cases (60%) had Y chromosomes by fluorescence in situ hybridization, which confirmed gestational origin. Although the 2 cases without a Y chromosome would ordinarily require molecular genotyping for paternal genetic material to establish gestational origin, in one of these cases a subsequent recurrence of yolk sac tumor allowed confirmation of its mediastinal origin. CONCLUSIONS.— Fluorescence in situ hybridization for detection of the X and Y chromosome centromeres is an effective screening test for gestational choriocarcinoma. It provided a definitive diagnosis of metastatic gestational choriocarcinoma in 3 of 5 potential cases that lacked a clinical history of gestational trophoblastic disease. An additional benefit is that more laboratories have the capability to perform fluorescence in situ hybridization than can perform molecular genotyping for definitive diagnosis.
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Affiliation(s)
- Rumeal D Whaley
- From the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis
| | - Rachel E Dougherty
- From the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis
| | - Liang Cheng
- From the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis
| | - Thomas M Ulbright
- From the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis
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6
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Umeda H, Kikuchi S, Kuroda S, Yano S, Tanaka T, Noma K, Nishizaki M, Kagawa S, Umeda Y, Fujiwara T. Long-term survival without recurrence after surgery for gastric yolk sac tumor-like carcinoma: a case report. Surg Case Rep 2021; 7:111. [PMID: 33956241 PMCID: PMC8102656 DOI: 10.1186/s40792-021-01199-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/03/2021] [Indexed: 11/11/2022] Open
Abstract
Background Gastric yolk sac tumor (YST)-like carcinoma is extremely rare, and its prognosis is poor, because most patients have widespread metastases at the time of diagnosis. We report a case of gastric YST-like carcinoma with an adenocarcinoma component without metastases in which curative resection was performed. Case presentation A 77-year-old man complaining of melena and dizziness due to anemia was diagnosed with poorly differentiated adenocarcinoma in the gastric cardia, with a benign ulcer in the gastric body. He underwent total gastrectomy with D2 lymph node dissection for the tumor. Histological examination of the resected specimens revealed a mixture of reticular and glandular neoplastic components morphologically. In the reticular area, an endodermal sinus pattern and some Schiller–Duval bodies were confirmed. Gastric YST-like carcinoma with adenocarcinoma components, T2N0M0 Stage IB, was diagnosed. Immunohistochemical analysis showed that the YST was positive for carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) and p53. In contrast, the adenocarcinoma was positive for p53 and negative for CEA and AFP. The patient remained healthy as of 7 years postoperatively, with no recurrence. Conclusions Routine medical examinations or endoscopic examinations for accidental symptom may be helpful for early diagnosis and good prognosis for gastric YST-like carcinoma, although the prognosis is generally poor.
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Affiliation(s)
- Hibiki Umeda
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Satoru Kikuchi
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Shinji Kuroda
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Shuya Yano
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, 700-8558, Japan
| | - Kazuhiro Noma
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Masahiko Nishizaki
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Shunsuke Kagawa
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yuzo Umeda
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Toshiyoshi Fujiwara
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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7
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Schrader E, Stephens AJ, Shroff S, Ahmad S, Holloway RW. Widespread choriocarcinoma metastases from de-differentiated gastro-esophageal junction primary adenocarcinoma: A case report with literature review. Gynecol Oncol Rep 2019; 31:100513. [PMID: 31886402 PMCID: PMC6920437 DOI: 10.1016/j.gore.2019.100513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 10/16/2019] [Accepted: 10/22/2019] [Indexed: 11/20/2022] Open
Abstract
Non-gestational choriocarcinomas are a rare presentation of germ cell tumors. In rare cases, choriocarcinoma can present from the de-differentiation of gastrointestinal adenocarcinomas. There are only 5 reported cases of choriocarcinoma de-differentiated from a gastric or esophageal primary lesion. No evidence-based treatment protocol exists for this presentation and all reported cases have poor outcomes.
Background Non-gestational choriocarcinomas represent a small subset of germ cell tumors. The majority of non-gestational choriocarcinomas arise from the gynecologic tract. In rare cases, they can originate from other sites, and very few such cases have been reported in peer-reviewed literature. We add to this small collection with an interesting case of non-gestational choriocarcinoma arising from a primary gastrointestinal adenocarcinoma. Case Presentation A 62-year-old female presented to the emergency department with ocular hemorrhage. Originally thought to have melanoma, full-body computed tomography (CT) revealed widespread metastases including a 3 cm hemorrhagic brain mass, hepatic metastases, and a mass at the gastro-esophageal (GE) junction. Pathology of the intracranial mass revealed a malignant neoplasm consistent with choriocarcinoma. Recent dilation and curettage (D&C) were negative for malignancy. Esophagogastroduodenoscopy (EGD) biopsy of the GE junction mass showed poorly differentiated adenocarcinoma, likely the primary lesion, while the liver biopsy matched the β-hCG staining pattern as seen in the brain. Conclusions Choriocarcinomas can rarely originate outside of the female reproductive tract (non-gestational, primary choriocarcinomas). In the infrequent cases where a gestational origin is clinically unlikely, the differential diagnosis includes a non-gestational primary choriocarcinoma and choriocarcinomatous differentiation in another primary malignancy. Careful correlation with imaging and clinico-pathologic studies is paramount to determining their origin and guiding further clinical treatment.
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Affiliation(s)
- Evan Schrader
- AdventHealth Cancer Institute, Gynecologic Oncology Program, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA
- Florida State University, College of Medicine, 250 E. Colonial Drive, Suite 200, Orlando, FL 32804, USA
- Corresponding authors at: Gynecologic Oncology Program, AdventHealth Cancer Institute, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA.
| | - Amanda J. Stephens
- AdventHealth Cancer Institute, Gynecologic Oncology Program, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA
- Corresponding authors at: Gynecologic Oncology Program, AdventHealth Cancer Institute, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA.
| | - Seema Shroff
- AdventHealth Cancer Institute, Gynecologic Oncology Program, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA
| | - Sarfraz Ahmad
- AdventHealth Cancer Institute, Gynecologic Oncology Program, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA
- Florida State University, College of Medicine, 250 E. Colonial Drive, Suite 200, Orlando, FL 32804, USA
| | - Robert W. Holloway
- AdventHealth Cancer Institute, Gynecologic Oncology Program, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA
- Florida State University, College of Medicine, 250 E. Colonial Drive, Suite 200, Orlando, FL 32804, USA
- Corresponding authors at: Gynecologic Oncology Program, AdventHealth Cancer Institute, 2501 N. Orange Ave., Suite 786, Orlando, FL 32804, USA.
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8
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Guzmán-López JC, Lino-Silva LS, Salcedo-Hernández RA, Zepeda-Najar C. Report of three cases of gastric choriocarcinomas-an emphasis on morphologic changes in the non-affected gastric mucosa. J Gastrointest Oncol 2019; 10:810-814. [PMID: 31392063 DOI: 10.21037/jgo.2019.01.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Primary gastric choriocarcinomas (PGC) are very rare and aggressive neoplasms with a worrisome prognosis. Most cases are reported in Asia and presented in middle-aged adults with male predominance. Most cases are associated with an intestinal adenocarcinoma; however, the pathogenesis of this tumor is uncertain. No previous reports exist of the characteristics of the non-tumoral stomach in these patients, and this data that could help to clarify their pathogenesis. We presented a series of three cases of PGC in Latin American patients, emphasizing the characteristics of non-neoplastic mucosa.
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Affiliation(s)
| | | | | | - César Zepeda-Najar
- Surgical Oncology, Hospital Ángeles Tijuana, Tijuana, Baja California Norte, Mexico
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9
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Lee JH, Lee JK, Kang DB. Primary Gastric Choriocarcinoma Coexisting with Adenocarcinoma. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2019; 73:350-354. [DOI: 10.4166/kjg.2019.73.6.350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/12/2019] [Accepted: 02/01/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Joo Hyun Lee
- Department of Surgery, Wonkwang University School of Medicine, Iksan, Korea
| | - Jeong Kyun Lee
- Department of Surgery, Wonkwang University School of Medicine, Iksan, Korea
| | - Dong Baek Kang
- Department of Surgery, Wonkwang University School of Medicine, Iksan, Korea
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10
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Qureshi A, Al-Moundhri M, Al-Shaibi M, Al-Haddabi I, Mittal A. Primary Gastric Yolk Sac Tumour. Sultan Qaboos Univ Med J 2018; 18:e383-e385. [PMID: 30607283 DOI: 10.18295/squmj.2018.18.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 02/08/2018] [Accepted: 04/12/2018] [Indexed: 01/19/2023] Open
Abstract
Primary gastric yolk tumours are extremely rare. We report a 52-year-old male who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2017 after having undergone a gastrectomy abroad due to a suspected poorly-differentiated adenocarcinoma. The patient subsequently returned to Oman to receive chemotherapy. However, while undergoing chemotherapy, an abdominal computed tomography scan revealed a lobulated mesenteric mass. Microscopic examination of the resected lesion confirmed a diagnosis of a yolk sac tumour. The mass was diffusely positive for α-fetoprotein (AFP) and a gastric carcinoma stain was negative. Gastrectomy slides from the patient's previous surgery were examined retrospectively. The morphology was typical for a yolk sac tumour and was negative for epithelial markers. An AFP stain showed diffuse immunoreactivity. Thus, the patient was deemed to have had a primary gastric yolk sac tumour which had later metastasised to the mesocolon. Germ cell tumour protocols were initiated and the patient responded well to treatment.
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Affiliation(s)
- Asim Qureshi
- Department of Pathology, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Maha Al-Shaibi
- Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ibrahim Al-Haddabi
- Department of Pathology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Alok Mittal
- Department of Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
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11
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Gastric cancer with adenocarcinoma and yolk sac tumor components: A rare entity. North Clin Istanb 2017; 4:275-278. [PMID: 29270580 PMCID: PMC5724926 DOI: 10.14744/nci.2017.60437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 01/10/2017] [Indexed: 11/24/2022] Open
Abstract
Despite a sharp worldwide decline in the incidence and mortality due to gastric cancer during the second half of the 20th century, gastric cancer remains the world’s second leading cause of cancer-related deaths. Variants of gastric cancer account for approximately 5% of all stomach carcinomas. Herein, we report on a rare case of combined germ cell tumor and adenocarcinoma that arose in the stomach of a 68-year-old woman with a high level of alpha-fetoprotein in the serum. Clinical and pathological findings are presented.
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12
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Choi JE, Choe AR, Yoon SE, Nam EM, Park H, Lee KE. Germ Cell Tumor Targeting Chemotherapy in Gastric Adenocarcinoma with an Endodermal Sinus Tumor Component: A Case Report. Chemotherapy 2016; 62:54-57. [PMID: 27351795 DOI: 10.1159/000447117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/25/2016] [Indexed: 11/19/2022]
Abstract
The most common sites for extragonadal germ cell tumors are the midline mediastinum, retroperitoneum and, much less frequently, the stomach. The stomach-originated primary germ cell tumor carries a poor prognosis, especially when metastasis occurs to the liver, with a mean survival time of 1 month. We describe the case of a 77-year-old male who presented with usual symptoms of gastric malignancy. Gastrectomy was performed. Histopathology of surgically resected tissue revealed a mixture of adenocarcinoma and endodermal sinus tumor components with α-fetoprotein production. After liver metastasis was identified, oxaliplatin and capecitabine were administered as palliative chemotherapy. The response was poor. For the second-line therapy, bleomycin, etoposide, and cisplatin (BEP) therapy was initiated. The overall response to these drugs was a partial response and the residual liver lesion was considered to be resectable. The patient died of pneumonia 11 months following the BEP session, representing an overall survival time of 22 months. Gastric adenocarcinoma with a germ cell tumor component is uncommon and an effective combination of chemotherapeutic agents is not yet clear. In this case, the patient received germ cell tumor-targeting chemotherapy and showed a durable response. Hence, germ cell-targeting cytotoxic agents have potential as the 'front-line regimen'.
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Affiliation(s)
- Jung Eun Choi
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, South Korea
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13
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Gastric adenocarcinoma with yolk sac tumor differentiation and liver metastasis of yolk sac tumor component. Case Rep Oncol Med 2013; 2013:923596. [PMID: 24294529 PMCID: PMC3835910 DOI: 10.1155/2013/923596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 10/01/2013] [Indexed: 11/20/2022] Open
Abstract
Gastric adenocarcinoma with yolk sac tumor (YST) differentiation has rarely been reported. We report a case of primary gastric adenocarcinoma with yolk sac tumor differentiation and liver metastases of the YST component in a 50-years-old patient. This was suspected due to high serum level of alpha fetoprotein in the presence of a gastric fundal tumor. Gastric carcinoma with yolk sac tumor component is a rare entity with a poor prognostic outcome.
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14
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Ji M, Lu Y, Guo L, Feng F, Wan X, Xiang Y. Endometrial carcinoma with yolk sac tumor-like differentiation and elevated serum β-hCG: a case report and literature review. Onco Targets Ther 2013; 6:1515-22. [PMID: 24187502 PMCID: PMC3810345 DOI: 10.2147/ott.s51983] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Endometrial carcinoma with a germ cell tumor component is a rare event. Here we report a uterine neoplasm with a unique combination of endometrioid adenocarcinoma and mixed germ cell malignant elements. A 28-year-old woman with abnormal vaginal bleeding, an abdominal mass, and elevated alfa-fetoprotein and beta-human chorionic gonadotropin (β-hCG) levels had a history of biopsy of an omental mass and chemotherapy in another hospital one month before her referral to our department. Histologic examination of the mass removed from the omentum revealed an endometrioid adenocarcinoma with yolk sac tumor-like differentiation. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, and removal of metastatic disease were then undertaken at our hospital. Postoperative chemotherapy was given. Eight months postoperatively, serum alfa-fetoprotein and β-hCG rose again. Cases with primary yolk sac tumors of the endometrium or endometrial carcinoma with trophoblastic differentiation in the literature were reviewed.
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Affiliation(s)
- Mingliang Ji
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, People's Republic of China
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15
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Ishida M, Okabe H. Endometrioid adenocarcinoma with choriocarcinomatous differentiation: A case report and review of the literature. Oncol Lett 2013; 6:655-658. [PMID: 24137385 PMCID: PMC3789090 DOI: 10.3892/ol.2013.1431] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 06/13/2013] [Indexed: 11/06/2022] Open
Abstract
A choriocarcinomatous component is rarely present in carcinomas of certain sites and few cases of choriocarcinomatous differentiation in endometrioid adenocarcinoma have been reported. The present study reports a case of endometrioid adenocarcinoma of the uterine corpus with choriocarcinomatous differentiation, and discusses the clinicopathological features of this rare tumor. A 59-year-old post-menopausal female presented with abnormal vaginal bleeding. Magnetic resonance imaging demonstrated a relatively well-circumscribed tumor in the uterine corpus and a total cystectomy was subsequently performed. A histopathological examination revealed two distinct components in the uterine corpus tumor. The first component comprised ~80% of the tumor and was composed of poorly-differentiated endometrioid adenocarcinoma. The remaining component consisted of mononucleated and syncytial giant cells containing rich eosinophilic cytoplasm and large pleomorphic nuclei with coarse chromatin. An immunohistochemical analysis revealed that these syncytial giant cells were positive for β-human chorionic gonadotropin (hCG). Therefore, a diagnosis of endometrioid adenocarcinoma with choriocarcinomatous differentiation was confirmed. The clinicopathological features of nine previously reported cases of this tumor were analyzed in addition to the present case. The majority of the patients were post-menopausal. Endometrial choriocarcinoma may be considered to have a highly aggressive clinical course, since nine of the 10 cases displayed metastases and four patients succumbed to the disease. The pathogenesis of the choriocarcinomatous component is not well understood. However, genetic studies have demonstrated that conventional carcinoma and choriocarcinomatous components share common genetic alterations. The choriocarcinomatous component represents aberrant differentiation of the conventional carcinoma, however, genetic analyses of endometrioid adenocarcinoma with choriocarcinomatous differentiation have not been performed.
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Affiliation(s)
- Mitsuaki Ishida
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
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16
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Govender D, Serra S, Chetty R. Collision tumor of the stomach: an unusual combination of adenocarcinoma and immature "neuroepitheliomatous" teratoma. Int J Surg Pathol 2011; 20:507-10. [PMID: 22142638 DOI: 10.1177/1066896911429941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 54-year-old woman was diagnosed with an asymptomatic gastric tumor during routine radiological investigation for staging of breast carcinoma. Subsequent endoscopic biopsy confirmed a poorly differentiated adenocarcinoma. Surgical resection of the stomach showed a tumor with 2 distinct components: a superficial lymphoepithelioma-like adenocarcinoma and a deeper submucosal component consistent with immature teratoma. There was lymph node metastasis. The patient is well without any evidence of disease 18 months post surgery.
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