Angiosarcoma, one of the least common sarcomas, occurs most commonly in the skin and soft tissues, and postirradiation angiosarcoma of the greater omentum is extremely rare. Only one reported case of postirradiation angiosarcoma involved the greater omentum. We describe the case of 74-year-old female with a history of cervical cancer treated with abdominal irradiation 5 years before. On admission, she had nausea, vomiting anorexia, and fatigue. She underwent an abdominal computed tomography scan that revealed an irregularly shaped tumor bounded by transverse colon. The patient died on the 34th hospital day. Autopsy revealed that the tumor was composed of anastomosing irregular vascular channels of variable calibers, involving the adipose tissue of the omentum. Histological studies suggested angiosarcoma. The definitive diagnosis was postirradiation angiosarcoma of the greater omentum, which is an extremely rare condition with an overall dismal prognosis.
Primary squamous cell carcinoma is rarely observed, with a reported incidence of 0.04-0.07 % of all gastric cancers. An 81-year-old male underwent chemoradiotherapy for type 1 gastric cancer of the posterior wall of the cardiac region in 2005. The tumor disappeared after 1 year of therapy, following which an area of white epithelium, approximately 30 mm in diameter and continuous with the esophageal mucosa, became visible. Biopsy of the white epithelium indicated normal squamous epithelium. An elevated lesion was subsequently detected in the area of white epithelium on upper gastrointestinal endoscopy during a follow-up examination 5 years after therapy. As a biopsy of the same site indicated squamous cell carcinoma, we performed endoscopic submucosal dissection. Histopathological examination indicated high-grade fibrosis due to radiotherapy and showed a moderately differentiated squamous cell carcinoma invading the scarred portion. We describe a case where the developmental process of a squamous cell carcinoma was observed using endoscopy, including narrow band imaging with magnification. This carcinoma likely originated from squamous metaplasia that developed after chemoradiotherapy was administered for a gastric cancer.
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