Gastric carcinoma with psammomatous calcification after Billroth II reconstruction: Case report and literature review

Abstract

A case of gastric carcinoma with psammomatous calcification arising in the remnant stomach after Billroth II reconstruction is reported. Borrmann type 1 gastric carcinoma was detected in the remnant stomach of an 82-year-old woman, who had a past history of distal partial gastrectomy for a perforated gastric ulcer, with Billroth II reconstruction at 40 years of age. Histologically, the tumor was a tubular adenocarcinoma that invaded the muscularis propria. Numerous psammoma bodies were found in the lumens of the tumor glands. Dystrophic calcification of gastric cancer is rare and psammomatous calcification of gastric cancer has only been reported in five cases previously. To our knowledge, this is the first case of gastric carcinoma with psammomatous calcification arising in the remnant stomach. We also review previously published reports regarding gastric carcinoma with psammomatous calcification.

Diffuse and psammomatous calcification in intestinal type gastric carcinoma: Report of two cases with literature review

“…In contrast to diffuse calcification occurring within the pools of mucin in mucinous gastric carcinoma (17), psammoma bodies are extremely rare in gastric carcinoma, with only six published cases (13)(14)(15)(16)(17)25). Case 2 reported herein is the seventh such case.…”

“…Osteopontin protein produced by macrophages has been reported to play a significant role in the development of psammomatous and non-psammomatous calcification in human neoplasms (13,14,32,33). Psammomatous calcification was also found to produce a parathyroid hormone (PTH)-like substance, suggesting a potential role in the pathogenesis of the psammomatous calcification (16).…”

“…Murayama et al (16) reported that a high level of PTH-like substance was noted in the tissue extract of their gastric carcinoma with psammomatous calcification, but serum calcium level and PTH were normal and the mechanism of calcification was different from metastatic calcification. Bone morphogenetic protein may be another potential contributor in the formation of psammoma bodies (14).…”

“…papillary serous tumor of the ovary, adenocarcinoma of the endometrium) (9,10). In addition, they can be seen in tumors originating from other organs such as the breast, lung, kidney, pituitary gland, colon (11), and stomach (12)(13)(14)(15)(16)(17). Dystrophic calcification is uncommon in gastric cancer and displays either mucin pool diffuse calcifications or psammomatous pattern (17).…”

Morphometric and Some Immunohistochemical Characteristics of Human Choroids Plexus Stroma and Psammoma Bodies

“…They are observed predominantly in the stroma of some pathologic formations, especially tumors, such as meningiomas (Kubota et al, 1984(Kubota et al, , 1985, papillary thyroid carcinoma (Das et al, 2004;Johannessen and Sobrinho-Simoes, 1980), papillary adenocarcinoma of sigmoid colon (Nakayama et al, 1997), gastric carcinoma (Kawahara et al, 2001), and endometrial cancer (Fausett et al, 2002). Their presence in these formations is very important diagnostic marker.…”