A Case of Gastric Remnant Adenocarcinoma with Enteroblastic Differentiation

Abstract

Gastric adenocarcinoma with enteroblastic differentiation is a rare disease and is classified as a special type of malignant epithelial tumor in the Japanese Clacification of Gastric Carcinoma. The patient was an 81-year-old man who had undergone distal gastrectomy for multiple primary gastric cancer 11 years earlier and was followed up with imaging methods except endoscopy at another hospital. He was referred to our hospital for a close examination because his CA19-9 level was slightly elevated to 25.7 U/mL in a routine blood test. A type 3 tumor of 4 cm in diameter was found on the lesser curvature of the gastric body, which was diagnosed as tub1-2 on a biopsy, and a total resection of the gastric remnant was performed. Intraoperative findings showed that the serosa of the lesser curvature side was tightly adherent to the lateral segment of the liver, and the liver was resected in combination with the tumor. Histopathological examination revealed adenocarcinoma cells with pale sporangia, strongly positive for SALL4 and weakly positive for AFP by immunostaining, and gastric adenocarcinoma with enteroblastic differentiation was diagnosed. Postoperative chemotherapy with FOLFOX was introduced but was interrupted on the 3^rd course because of anorexia. This is a rare disease with an extremely poor prognosis and requires close follow-up.