内視鏡下生検にて術前診断された胃原発真性癌肉腫の１例

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  • A Case of True Gastric Carcinosarcoma Diagnosed Preoperatively by Endoscopic Biopsies

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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.

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