Abstract
Adenosquamous cell carcinoma (ASC) originating in the stomach is a relatively rare entity. ASC accounts for 0.26_??_0.53% of all resected cases of gastric cancer. Recently, we experienced a case of primary ASC of the stomach in an 81-year-old man. The patient was preoperatively diagnosed as having squamous cell carcinoma in the cardiac region of the stomach. Under the diagnosis of advanced gastric cancer, a proximal subtotal gastrectomy combined with a partial resection of the pancreas tail and a splenectomy was performed. Macroscopic finding revealed a large gastric tumor, and 3 type cancer measuring 10×10cm was identified in the upper portion of the stomach. Histologically, moderately differentiated adenocarcinoma mixed with moderately differentiated squamous cell carcinoma with keratinizing cells was recognized. Consequently, this tumor was diagnosed as ASC. In this patient, there were no ectopic squamous cells, nor undifferentiated carcinoma cells. A possible histogenesis of squamous metaplasia in pre-existing adenocarcinoma was considered in this case. Clinical staging was rated as Stage IIIA (pSI, pN0, sP0, sH0, sM0). ASC of the stomach demands extended radical operation, because there is a case that no having regional lymph-node metastasis or peritoneal dissemination even if huge tumor as this case.
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