A Case of True Gastric Carcinosarcoma Diagnosed Preoperatively by Endoscopic Biopsies

Tsunenobu Takase, Akio Harada, Toyohisa Yaguchi, Masaki Kajikawa, Shigeki Nakayama, Takashi Shirota, Yukiyasu Okamura, Takashi Sugae, Yoshikuni Inokawa and Takaaki Nakamura*

Department of Surgery and Department of Pathology*, Aichi Prefectural Koseiren Kainan Hospital

Gastric carcinosarcoma is rare and very few cases differentiating toward specific nonepithelial tissue have been reported. A 74-year-old man admitted for epigastralgia and anorexia was diagnosed with true gastric carcinosarcoma based on endoscopic biopsy showing lesions differentiating toward chondrosarcoma. We conducted total gastrectomy with local resection of the lateral hepatic segment and diaphragm involvement. The primary tumor lesion was composed pathologically of carcinomatous and chondrosarcomatous elements. Carcinomatous elements showed poorly to moderately differentiated adenocarcinoma, along with small-cell carcinoma. Sarcomatous elements showed spindle cells and cartilaginous components. Metastatic lymph nodes contained only carcinomatous elements. The man died of multiple liver metastases 5 months after surgery. The autopsy showed that pathological findings of liver metastases were similar to those of the primary tumor, suggesting the potential of sarcomatous elements for hepatic metastasis. We reported the present case to add to reports on clinical cases of true gastric carcinosarcoma, because fewer than 10 cases have been reported to date.

Key words
carcinosarcoma, stomach

Reprint requests
Tsunenobu Takase Department of Surgery, Aichi Prefectural Koseiren Kainan Hospital
396 Minamihonden, Maegasushinden, Yatomi-cho, Ama-gun, 498-8502 JAPAN

Accepted
September 28, 2005

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