RESUMO
We report herein a case of gastric undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. A 57-year-old man was referred after a gastroscopy for anemia evaluation. Gastroscopy revealed an approximately 3 cm ulcerofungating mass occupying the greater curvature of stomach body. Biopsy results revealed a poorly differentiated adenocarcinoma. Left gastric lymph node was enlarged, but there were no evidence of distant metastasis on the abdominal CT. He underwent a radical subtotal gastrectomy and gastroduodenostomy with dissection of the enlarged lymph nodes. Postsurgical histological examination revealed an undifferentiated carcinoma with focal yolk sac tumor and hepatoid carcinoma differentiation. Immunohistochemical staining revealed that the tumor cells were focal positive for AFP, anti-hepatocyte antibody.
Assuntos
Adenocarcinoma , Anemia , Biópsia , Carcinoma , Tumor do Seio Endodérmico , Gastrectomia , Gastroscopia , Linfonodos , Metástase Neoplásica , Estômago , Saco VitelinoRESUMO
Gastric neuroendocrine carcinoma is a rare cause of gastric malignant tumors and has a poor prognosis. The carcinoma has histologic features characterized by irregular shape, thick cords and trabeculae of tumor cells. Immunohistochemical staining of tumor cells shows synaptophysin as positive. We report a case of neuroendocrine carcinoma of the stomach initially presenting as panperitonitis because of spontaneous tumor perforation. A 70-year-old man visited our emergency room because of abdominal pain. A preoperative abdominal CT showed a pneumoperitoneum in the upper abdomen suggesting ulcer perforation of the stomach. An emergent laparotomy with primary repair of the perforation was performed. After general conditions of the patient improved, endoscopic biopsy was performed. Pathologic examination revealed that the tumor was a gastric neuroendocrine carcinoma. Radical subtotal gastrectomy was additionaly performed.
Assuntos
Humanos , Abdome , Dor Abdominal , Biópsia , Carcinoma Neuroendócrino , Emergências , Gastrectomia , Laparotomia , Pneumoperitônio , Prognóstico , Estômago , Sinaptofisina , ÚlceraRESUMO
Gastric neuroendocrine carcinoma is a rare cause of gastric malignant tumors and has a poor prognosis. The carcinoma has histologic features characterized by irregular shape, thick cords and trabeculae of tumor cells. Immunohistochemical staining of tumor cells shows synaptophysin as positive. We report a case of neuroendocrine carcinoma of the stomach initially presenting as panperitonitis because of spontaneous tumor perforation. A 70-year-old man visited our emergency room because of abdominal pain. A preoperative abdominal CT showed a pneumoperitoneum in the upper abdomen suggesting ulcer perforation of the stomach. An emergent laparotomy with primary repair of the perforation was performed. After general conditions of the patient improved, endoscopic biopsy was performed. Pathologic examination revealed that the tumor was a gastric neuroendocrine carcinoma. Radical subtotal gastrectomy was additionaly performed.
Assuntos
Humanos , Abdome , Dor Abdominal , Biópsia , Carcinoma Neuroendócrino , Emergências , Gastrectomia , Laparotomia , Pneumoperitônio , Prognóstico , Estômago , Sinaptofisina , ÚlceraRESUMO
Gastroduodenal fistula or double pylorus is a very rare condition. It is a fistulous communication between gastric antrum and duodenal bulb. It can be either congenital or acquired. In most cases it is thought to be a complication of gastric ulcer. We recently experienced a case of gastroduodenal fistula in 70 year-old man presenting as epigastric pain. He was diagnosed with non ST elevation myocardial infarction previously, and was taking aspirin. Gastroduodenal communication was revealed by endoscopy. We report a case of gastroduodenal fistula that developed in man who was taking aspirin, with review of the literature.