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A rare case of xanthogranuloma of the stomach masquerading as an advanced stage tumor.

Kinoshita H, Yamaguchi S, Sakata Y, Arii K, Mori K, Kodama R - World J Surg Oncol (2011)

Bottom Line: A 65-year-old female was referred to our hospital because of epigastralgia.During a physical examination, a defined abdominal mass was palpable in the region of the left hypochondrium.Further accumulation and investigation of this entity is necessary.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Naga Municipal Hospital, 1282, Uchita, Kinokawa, Wakayama 649-6414, Japan. hkino@nagahp.jp

ABSTRACT

Background: Xanthogranuloma of the stomach is an extremely rare disease, and this lesion has only been found to coexist with early gastric cancer in 2 cases in the literature.

Case presentation: We report a case of xanthogranuloma of the stomach combined with early gastric cancer that mimicked an advanced stage tumor. A 65-year-old female was referred to our hospital because of epigastralgia. During a physical examination, a defined abdominal mass was palpable in the region of the left hypochondrium. Imaging studies revealed an advanced gastric cancer, which was suspected of having infiltrated the abdominal wall. Total gastrectomy and resection of the regional lymph node and abdominal wall were performed. Histopathologic examination of the resected specimen demonstrated xanthogranuloma combined with early gastric cancer.

Conclusion: Xanthogranuloma presenting as a form of SMT (submucosal tumor) of the stomach is an extremely rare disease, and diagnosing it preoperatively is difficult. Further accumulation and investigation of this entity is necessary.

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Related in: MedlinePlus

Macroscopic examination of the specimens. a. Upon macroscopic examination, the specimens showed an elevated and superficial depressed-type (IIa+IIc type) gastric cancer (arrow) and an elevated lesion similar to a submucosal tumor (arrow head). b. The abdominal wall (arrow) was resected together with the stomach.
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Figure 2: Macroscopic examination of the specimens. a. Upon macroscopic examination, the specimens showed an elevated and superficial depressed-type (IIa+IIc type) gastric cancer (arrow) and an elevated lesion similar to a submucosal tumor (arrow head). b. The abdominal wall (arrow) was resected together with the stomach.

Mentions: Open surgery was carried out and revealed that the tumor had infiltrated into the abdominal wall. Therefore, total gastrectomy and resection of the regional lymph node and parts of the abdominal wall were performed. Upon macroscopic examination, the specimens showed an elevated and superficial depressed-type (IIa+IIc type) gastric cancer, and the adjacent tumor had extended into the abdominal wall beyond the gastric serosa (Figure 2). Histopathological examination of the specimens demonstrated moderately differentiated adenocarcinoma without metastasis to the resected lymph nodes and xanthogranuloma consisting of foamy histiocytes, many lymphocytes, plasma cells, and granulocytes which were immunohistochemically positive for CD68 and were non reactive with CAM5.2, AE1/3 and S-100 protein (Figure 3). The xanthogranuloma was located near to the gastric cancer, but was not in contact with it. The patient recovered rapidly and was discharged on postoperative day 16. She has been symptom free ever since.


A rare case of xanthogranuloma of the stomach masquerading as an advanced stage tumor.

Kinoshita H, Yamaguchi S, Sakata Y, Arii K, Mori K, Kodama R - World J Surg Oncol (2011)

Macroscopic examination of the specimens. a. Upon macroscopic examination, the specimens showed an elevated and superficial depressed-type (IIa+IIc type) gastric cancer (arrow) and an elevated lesion similar to a submucosal tumor (arrow head). b. The abdominal wall (arrow) was resected together with the stomach.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3142508&req=5

Figure 2: Macroscopic examination of the specimens. a. Upon macroscopic examination, the specimens showed an elevated and superficial depressed-type (IIa+IIc type) gastric cancer (arrow) and an elevated lesion similar to a submucosal tumor (arrow head). b. The abdominal wall (arrow) was resected together with the stomach.
Mentions: Open surgery was carried out and revealed that the tumor had infiltrated into the abdominal wall. Therefore, total gastrectomy and resection of the regional lymph node and parts of the abdominal wall were performed. Upon macroscopic examination, the specimens showed an elevated and superficial depressed-type (IIa+IIc type) gastric cancer, and the adjacent tumor had extended into the abdominal wall beyond the gastric serosa (Figure 2). Histopathological examination of the specimens demonstrated moderately differentiated adenocarcinoma without metastasis to the resected lymph nodes and xanthogranuloma consisting of foamy histiocytes, many lymphocytes, plasma cells, and granulocytes which were immunohistochemically positive for CD68 and were non reactive with CAM5.2, AE1/3 and S-100 protein (Figure 3). The xanthogranuloma was located near to the gastric cancer, but was not in contact with it. The patient recovered rapidly and was discharged on postoperative day 16. She has been symptom free ever since.

Bottom Line: A 65-year-old female was referred to our hospital because of epigastralgia.During a physical examination, a defined abdominal mass was palpable in the region of the left hypochondrium.Further accumulation and investigation of this entity is necessary.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Naga Municipal Hospital, 1282, Uchita, Kinokawa, Wakayama 649-6414, Japan. hkino@nagahp.jp

ABSTRACT

Background: Xanthogranuloma of the stomach is an extremely rare disease, and this lesion has only been found to coexist with early gastric cancer in 2 cases in the literature.

Case presentation: We report a case of xanthogranuloma of the stomach combined with early gastric cancer that mimicked an advanced stage tumor. A 65-year-old female was referred to our hospital because of epigastralgia. During a physical examination, a defined abdominal mass was palpable in the region of the left hypochondrium. Imaging studies revealed an advanced gastric cancer, which was suspected of having infiltrated the abdominal wall. Total gastrectomy and resection of the regional lymph node and abdominal wall were performed. Histopathologic examination of the resected specimen demonstrated xanthogranuloma combined with early gastric cancer.

Conclusion: Xanthogranuloma presenting as a form of SMT (submucosal tumor) of the stomach is an extremely rare disease, and diagnosing it preoperatively is difficult. Further accumulation and investigation of this entity is necessary.

Show MeSH
Related in: MedlinePlus