A Case Report of Gastric Poorly Differentiated Adenocarcinoma with Squamous Cell Carcinoma in Metastatic Focus

Fumihiro Yoshimura, Yoshiaki Tsuji, Yasushi Hara, Masataka Ushijima, Mitsuteru Morimoto and Jyun Taguchi*

Department of Surgery and Department of Pathology*, Amagi Asakura Medical Association Asakura Hospital

We report an extremely rare case of poorly differentiated gastric adenocarcinoma with totally cornified squamous cell carcinoma in metastatic focus. A 59-year-old man seen for abdominal pain and distention and admitted for closer examination of an epigastric tumor was found in gastric endoscopy to have a defective extension from the corpus to the antrum of the stomach. A histological diagnosis of poorly differentiated adenocarcinoma was made based on the biopsy specimen. A swollen No.4d lymph node 4 cm in diameter was suspected in abdominal CT, necessitating total gastrectomy, partial resection of the transverse colon, cholecystectomy, and ρ-Roux-en-Y reconstruction. Although histologic ally the gastric cancer was poorly differentiated adenocarcinoma, the histologic type of metastatic lymph nodes and metastatic focus developing later was cornified squamous cell carcinoma. Pathological autopsy showed no squamous cell carcinoma components as a primary focus in organs, including the esophagus, lung, and testis. We strongly suggest that this rare case indicates the possibility of poorly differentiated adenocarcinoma transformed into cornified squamous cell carcinoma in metastatic focus or in the process of metastasis.

Key words
gastric cancer, squamous cell carcinoma in metastatic lymph nodes, adenocarcinoma transformed into squamous cell carcinoma

Reprint requests
Fumihiro Yoshimura Department of Surgery, Amagi Asakura Medical Association Asakura Hospital
422 Raiha, Amagi, 838-0069 JAPAN

Accepted
March 30, 2005

To read the PDF file you will need Abobe Reader installed on your computer.