Chondrosarcomatous Differentiation in Diffuse-Type Gastric Carcinoma

Abstract

The vast majority of malignant neoplasm of the stomach is represented by epithelial tumors composed of tubular, acinar, or papillary structures or consisting of a complex mixture of isolated cells with variable morphologies in combination with glandular, trabecular, or solid nests. The most commonly used classification systems are the WHO and the Lauren systems. The diffuse type of gastric cancer is more aggressive, is located in the proximal part of the stomach, is more frequent in young patients, and frequently displays signet ring cell differentiation [1].Several other types of gastic carcinomas exist, which do not constitute an integral part of the above classifications. In particular, adenosquamous carcinoma, which probably comprises less than 0.5% of gastric carcinomas, is characterized by the coexistence of variable proportions of adenocarcinoma and squamous cell carcinoma within a tumor [2]. Other types of combination tumors are even rarer, such as combinations between adenocarcinoma and choriocarcinoma or embryonal carcinoma or carcinoma with hepatoid differentiation (hepatoid adenocarcinoma) [3]. As in the esophagus, carcinomas with a sarcomatous component (so-called carcinosarcomas) have been sporadically described in the stomach [4].Here we report a patient with primary epithelial gastric neoplasm and a concomitant sarcomatous component, in which the latter was represented by chondromatous differentiation. To the best of our knowledge, this is the first case to be described. Case reportA 45-year-old man reported a history of recent-onset (1-month) epigastric pain associated with sporadic episodes of vomiting. Since in the last vomiting episode fresh blood was present, he was admitted to our surgical unit. Physical examination at admission was unremarkable, as well as blood chemistry; in particular, no anemia was present.An upper gastrointestinal endoscopy showed the presence of a large vegetating antral neoplasm, ulcerated, causing pyloric stenosis. Endoscopic biopsies were consistent with adenocarcinoma.After abdominal ultrasound and TC scans, not showing other neoplastic areas, the patient was operated, and a total gastrectomy with lymphadenectomy and cholecystectomy was carried out. The postoperative period was uneventful, except for a mild anemia requiring one transfusion of red blood Springer

Histological heterogeneity and distributional difference of gastric carcinosarcoma: report of 4 cases and literature review

“…Upon review of the literature, 76 cases were identified (Table II) [1,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51]. The clinical features of patients with gastric carcinosarcoma appeared to be nonspecific with epigastric pain, weight loss, and melena, as the most common complaints.…”

Chondrosarcome primitif de l’estomac

“…Par ailleurs, certaines tumeurs primitives peuvent donner de métastases gastriques, comme le mélanome, le cancer du sein et le cancer de poumon, un cas de chondrosarcome métastatique dans l'estomac ayant été observé [3]. L'apparition d'un carcinome gastrique avec différentiation chondrosarcomateuse a été rapportée une seule fois dans la littérature [1]. Mais notre observation est la première d'une tumeur constituée uniquement de tissu chondrosarcomateux au niveau gastrique.…”

“…La plupart des cancers de l'estomac sont de tumeurs épithéliales composées de structures tubulaires, acinaires ou papillaires. Néanmoins des composants sarcomateux ont été décrits rarement et même un cas de carcinome gastrique épithélial de type diffus avec différenciation chondrosarcomateuse en son sein a été observé [1]. Nous rapportons un cas de chondrosarcome primitif pur de l'estomac sans composante épithéliale.…”