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A Rare Case of a Primary Squamous Cell Carcinoma of the Stomach Presenting as a Submucosal Mass.

von Waagner W, Wang Z, Picon AI - Case Rep Surg (2015)

Bottom Line: Imaging of the chest, abdomen, and pelvis showed no evidence of local or distant metastasis.Pathology showed a gastric squamous cell carcinoma (SCC) invading the diaphragm, with negative margins of resection, and one positive perigastric lymph node.He received chemoradiation, but the patient expired 27 months after surgery.

View Article: PubMed Central - PubMed

Affiliation: Division of Surgical Oncology, Department of Surgery, Staten Island University Hospital, 256 B Mason Avenue, Staten Island, NY 10305, USA.

ABSTRACT
We report a case of a 70-year-old man, with a status after aortic valve replacement, who presented with melena and hypotension. On physical examination, he was hypotensive, but he responded to resuscitation. Esophagogastroduodenoscopy revealed a submucosal mass in the gastric fundus. Imaging of the chest, abdomen, and pelvis showed no evidence of local or distant metastasis. He underwent a partial diaphragmatic resection, gastrectomy, lymphadenectomy, and Roux-en-Y esophagojejunostomy. Pathology showed a gastric squamous cell carcinoma (SCC) invading the diaphragm, with negative margins of resection, and one positive perigastric lymph node. He received chemoradiation, but the patient expired 27 months after surgery.

No MeSH data available.


Related in: MedlinePlus

(a) Histopathological examination showing a moderately differentiated squamous cell carcinoma with keratinization (×100). Keratin pearl (black arrow). Mosaic cell arrangement with sharp border (red arrow). (b) Tumor invasion of the diaphragm (×100) (red arrow). (c) Lymphovascular invasion is present (×40) (black arrow). (d) Tumor with nerve invasion (×40) (black arrow).
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fig3: (a) Histopathological examination showing a moderately differentiated squamous cell carcinoma with keratinization (×100). Keratin pearl (black arrow). Mosaic cell arrangement with sharp border (red arrow). (b) Tumor invasion of the diaphragm (×100) (red arrow). (c) Lymphovascular invasion is present (×40) (black arrow). (d) Tumor with nerve invasion (×40) (black arrow).

Mentions: The surgical specimen was composed of a total gastrectomy with partial resection of adherent diaphragm. There was a submucosal tan/white soft mass measuring 4.0 × 3.5 × 3.5 cm, with focal necrosis, located at the fundus. The tumor did not extend to the surgical specimen margins. Examination of the gastric and duodenal tissue revealed no further tumor mass. Histologically, the tumor showed moderately differentiated squamous cells with keratinization and without glandular differentiation (Figure 3(a)). The tumor located predominantly in the submucosa through the serosa and with direct invasion to the adjacent diaphragm striated muscle (Figure 3(b)). Lymphovascular invasion and perineural invasion were observed adjacent to the tumor (Figures 3(c) and 3(d)), respectively. Further immunohistochemistry showed tumor cells with strong coexpression of CK5/6 and p63, which are indicators of squamous cell carcinoma (Figure 4(a), dual staining), but negative for p16 (Figure 4(b)), CD117 (indicator of gastrointestinal stromal tumor, Figure 4(c)), and CK7 (indicator of adenocarcinoma, Figure 4(d)). One perigastric lymph node (1/13) exhibited metastatic squamous cell carcinoma.


A Rare Case of a Primary Squamous Cell Carcinoma of the Stomach Presenting as a Submucosal Mass.

von Waagner W, Wang Z, Picon AI - Case Rep Surg (2015)

(a) Histopathological examination showing a moderately differentiated squamous cell carcinoma with keratinization (×100). Keratin pearl (black arrow). Mosaic cell arrangement with sharp border (red arrow). (b) Tumor invasion of the diaphragm (×100) (red arrow). (c) Lymphovascular invasion is present (×40) (black arrow). (d) Tumor with nerve invasion (×40) (black arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4491394&req=5

fig3: (a) Histopathological examination showing a moderately differentiated squamous cell carcinoma with keratinization (×100). Keratin pearl (black arrow). Mosaic cell arrangement with sharp border (red arrow). (b) Tumor invasion of the diaphragm (×100) (red arrow). (c) Lymphovascular invasion is present (×40) (black arrow). (d) Tumor with nerve invasion (×40) (black arrow).
Mentions: The surgical specimen was composed of a total gastrectomy with partial resection of adherent diaphragm. There was a submucosal tan/white soft mass measuring 4.0 × 3.5 × 3.5 cm, with focal necrosis, located at the fundus. The tumor did not extend to the surgical specimen margins. Examination of the gastric and duodenal tissue revealed no further tumor mass. Histologically, the tumor showed moderately differentiated squamous cells with keratinization and without glandular differentiation (Figure 3(a)). The tumor located predominantly in the submucosa through the serosa and with direct invasion to the adjacent diaphragm striated muscle (Figure 3(b)). Lymphovascular invasion and perineural invasion were observed adjacent to the tumor (Figures 3(c) and 3(d)), respectively. Further immunohistochemistry showed tumor cells with strong coexpression of CK5/6 and p63, which are indicators of squamous cell carcinoma (Figure 4(a), dual staining), but negative for p16 (Figure 4(b)), CD117 (indicator of gastrointestinal stromal tumor, Figure 4(c)), and CK7 (indicator of adenocarcinoma, Figure 4(d)). One perigastric lymph node (1/13) exhibited metastatic squamous cell carcinoma.

Bottom Line: Imaging of the chest, abdomen, and pelvis showed no evidence of local or distant metastasis.Pathology showed a gastric squamous cell carcinoma (SCC) invading the diaphragm, with negative margins of resection, and one positive perigastric lymph node.He received chemoradiation, but the patient expired 27 months after surgery.

View Article: PubMed Central - PubMed

Affiliation: Division of Surgical Oncology, Department of Surgery, Staten Island University Hospital, 256 B Mason Avenue, Staten Island, NY 10305, USA.

ABSTRACT
We report a case of a 70-year-old man, with a status after aortic valve replacement, who presented with melena and hypotension. On physical examination, he was hypotensive, but he responded to resuscitation. Esophagogastroduodenoscopy revealed a submucosal mass in the gastric fundus. Imaging of the chest, abdomen, and pelvis showed no evidence of local or distant metastasis. He underwent a partial diaphragmatic resection, gastrectomy, lymphadenectomy, and Roux-en-Y esophagojejunostomy. Pathology showed a gastric squamous cell carcinoma (SCC) invading the diaphragm, with negative margins of resection, and one positive perigastric lymph node. He received chemoradiation, but the patient expired 27 months after surgery.

No MeSH data available.


Related in: MedlinePlus