Adenosquamous Carcinoma of the Stomach: Report of Two Cases

The author reports two cases of adenosquamous carcinoma of stomach. The first case is an 87-year-old woman who was admitted to our hospital because of nausea and vomiting. Endoscopy revealed a large type 4 tumor in the stomach, and biopsy showed squamous cell carcinoma. Total gastrectomy, cholecystectomy, splenectomy and lymph node dissection were performed. Pathologically, the gastric tumor consisted of a mixture of adenocarcinoma (30% in area) and squamous cell carcinoma (70% in areas). The adenocarcinoma consisted of signet ring cell carcinoma, poorly differentiated carcinoma, and tubular adenocarcinoma. Carcinoma cells invaded into the serosa. The gall bladder, lymph nodes and peritoneum showed metastases of adenocarcinoma. The patient died of five months after operation. The second case is a granulocyte-colony stimulating factor producing carcinoma. A 77-year-old woman was admitted to our hospital because of epigastralgia. Marked leukocytosis was present without inflammation. Endoscopic examination revealed a large type 3 tumor, and biopsy showed squamous cell carcinoma. Gastrectomy and lymph node dissection was performed. Pathologically the gastric tumor was composed of a mixture of adenocarcinoma (10%) and squamous cell carcinoma (90%). The carcinoma invaded into subserosa. Lymphovascular permeation is present. The adenocarcinoma element consisted of signet ring cell carcinoma. Tumor cells were immunohistochemically positive for granulocyte-colony stimulating factor. The lymph nodes showed metastases of signet ring cell carcinoma. The patient showed systemic metastasis, and died eight months after the operation.