Primary gastric adenosquamous carcinoma in a Caucasian woman: a case report

Abstract

IntroductionMost gastric tumors are adenocarcinomas. Primary gastric adenosquamous carcinoma is a rare malignancy, mostly associated with Asian populations. It constitutes less than one percent of all gastric carcinomas and its clinical presentation is the same as adenocarcinoma. It occurs more frequently in the proximal stomach, usually presents with muscular layer invasion and tends to be found in advanced stages at diagnosis, with a worse prognosis than adenocarcinoma.Case presentationWe report the case of an 84-year-old Caucasian woman with an adenosquamous carcinoma extending to her serosa with lymphatic and venous invasion (T3N1M1). Nodal and hepatic metastasis presented with both cellular types, with dominance of the squamous component.ConclusionsAdenosquamous gastric cancer is a rare diagnosis in western populations. We present the case of a woman with a very aggressive adenosquamous carcinoma with a preponderance of squamous cell component in the metastasis. Several origins have been proposed for this kind of carcinoma; either evolution from adenocarcinoma de-differentiation or stem cell origin might be possible. The hypothesis that a particular histological type of gastric cancer may arise from stem cells might be a field of research in oncological disease of the stomach.

Clinicopathological characteristics, diagnosis, treatment, and outcomes of primary gastric adenosquamous carcinoma

“…Rolleston and Trevor first reported on gastric ASC in 1905. Notably, the majority of patients with ASC were diagnosed at an advanced stage, with high-grade malignancy and poor prognosis [ 2 , 4 ]. ASC occurrence is more frequent in the proximal stomach among middle-aged and aged populations, as well as among Asian men [ 1 , 5 , 16 ].…”

“…Adenosquamous carcinoma (ASC) is a rare entity that occurs throughout the entire alimentary tract [ 1 - 3 ]. The incidence of primary gastric ASC is uncommon, accounting for less than 1% of the total gastric carcinomas worldwide [ 4 , 5 ] and mostly affecting Asians. Primary gastric ASC exhibits early tumor progression and poorer prognosis than the typical gastric adenocarcinoma [ 4 ].…”

“…The incidence of primary gastric ASC is uncommon, accounting for less than 1% of the total gastric carcinomas worldwide [ 4 , 5 ] and mostly affecting Asians. Primary gastric ASC exhibits early tumor progression and poorer prognosis than the typical gastric adenocarcinoma [ 4 ]. The biological behavior of ASC is usually determined by the adenocarcinoma component [ 6 , 7 ].…”

“…Given the rarity of these carcinomas, most literatures are based on case reports [ 2 , 4 , 5 , 7 - 11 ]. The histogenesis of these tumors has been debated considerably, and clinical therapies and prognosis of ASC have not been well established to date [ 12 ].…”

A case of two primary gastric malignancies: adenocarcinoma and squamous cell carcinoma of the stomach

“…2,3 In addition, cases of primary gastric adenosquamous carcinoma also have been reported. 4,5 We present a case of a woman with two gastric tumors in separate locations with different histological characteristics; one an adenocarcinoma, the other squamous cell carcinoma. To our knowledge there are no reported cases of two separate gastric primary tumors consisting of these two pathologic diagnoses.…”