Adenosquamous Gastric Carcinoma in a Case of Aplastic Anemia

Abstract

An 80-year-old woman with aplastic anemia admitted for general fatigue was found in laboratory testing to have escalated pancytopenia. CA19-9 and CEA serum concentrations were within normal limits. Gastrointestinal examination showed type 2 cancer of the gastric antrum, that biopsy indicated was moderately differentiated tubular adenocarcinoma. Computed tomography (CT) showed no metastatic lesion. We conducted distal gastrectomy with standard D2 lymph node dissection. The histopathological diagnosis was adenosquamous carcinoma, judged based in Japanese classification of gastric carcinoma (2nd English edition) to be stage pT3 (SE) pN0 H0 P0 CY0 M0, fStage II. The woman remains alive without recurrence in the 15 months after surgery.
Granulocyte colony-stimulating factor (G-CSF) serum concentration is often elevated in those with aplastic anemia. G-CSF is assumed to confer growth advantages in several carcinoma types, including adenosquamous gastric carcinoma, and aplastic anemia may promote adenosquamous gastric carcinoma occurrence.