2020 Volume 53 Issue 10 Pages 776-783
A 69-year-old male patient was referred to our hospital to undergo treatment for multiple gastric cancers with the complaint of melena. Gastroendoscopy showed an ulcerative lesion surrounding an elevation in the middle gastric body and a shallow depressed lesion with marginal elevation in the lower gastric body. Biopsy specimens revealed poorly-differentiated adenocarcinoma and poorly- to moderately-differentiated adenocarcinoma, respectively. Enhanced abdominal CT imaging showed some enlarged lymph nodes in the perigastric region (cT4aN+M0 Stage III). We performed total gastrectomy and splenectomy with D2+ lymph node dissection. Histological examination showed that the former was a type II tumor with adenosquamous carcinoma invading into the subserosa. In addition, adenocarcinoma components were seen in the No. 16-b1-latero lymph node by HE. Since gastric primary adenosquamous carcinoma account for 0.2–0.6% of all gastric cancers, multiple synchronous gastric cancers with adenosquamous carcinoma and the common type are extremely rare and the clinical outcome remains to be elucidated.
