A Case Report of Gastric Adenocarcinoma with Adenosquamous Cell Carcinoma in Metastatic Lymph Nodes

Fumiaki Kawano, Ryo Sekiya, Tatsuo Shinohara, Takaaki Nakahira, Ken Nakashima, Yusuke Enomoto, Kunihide Nakamura, Yasunori Matsuzaki and Toshio Onitsuka

The 2nd Department of Surgery, Miyazaki Medical College

We reported a case of gastric adenocarcinoma with metastatic lymph nodes showing adenosquamous cell carcinoma. A 76-year-old woman with an abnormality in gastroscopy and admitted to our hospital was found to have a 0-IIc lesion on the posterior wall of the middle body and biopsy showed adenocarcinoma. We conducted total gastrectomy combined with distal pancreatectomy and splenectomy and Roux-en Y reconstruction anastomosis. The pancreatic body was excised for lymph node invasion on the lesser curvature. Macroscopic findings showed 0-IIc cancer measuring 4.0×2.5 cm on the posterior wall of the middle body and swollen lymph nodes. Histologically, the lesion was diagnosed as poorly differentiated adenocarcinoma with signet ring cells and invasion limited to the submucosa. Microscopic findings of metastatic lymph nodes showed adenosquamous cell carcinoma -a very rare occurrence supporting the hypothesis that the majority of adenosquamous cell carcionoma probably arises from squamous metaplasia of adenocarcinoma.

Key words
gastric adenocarcinoma, adenosquamous cell carcinoma in metastatic lymph nodes, squamous metaplasia of the adenocarcinoma

Reprint requests
Fumiaki Kawano The 2nd Department of Surgery, Miyazaki Medical College 5200 Kihara, Kiyotake, Miyazaki, 889-1692 JAPAN

Accepted
April 30, 2003

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