Subscribe to RSS
DOI: 10.1055/s-0044-1797806
GASTRIC ENDODERMIC TUMOR
Authors
Presentation: Male patient, 41 years old, BMI: 22, PS: 1, healthy. Four months ago onset of epigastric pain, vomiting after feeding, melena episodes and weight loss of 10kg. Physical examination: BEG, hypocolored 1 + / 4 +. Abdomen: Flaccid, without palpable masses. No lymph node enlargement. Laboratory tests (08/28/19): Hb: 6.1g / dL Ht: 21.5%. EDA (08/29/18): Infiltrating ulcerative lesion extending through the small curvature and part of the anterior and posterior walls of the distal antrum. Type Bormann III. AP: Lauren's moderately differentiated, ulcerated, and infiltrative intestinal-type adenocarcinoma. CT (08/30/18): Irregular parietal thickening in the small curvature, body and gastric antrum, poorly defined limits. Perilesional fat density, lymph node enlargement in this topography, measuring up to 3.0 × 2.5cm, some with foci of calcification inside. Due to bleeding, on 09/21/18 total gastrectomy + D2 + Roux-en-Y lymphadenectomy was performed. AP Outcome: Gastric endodermal sinus tumor of the glandular pattern. Size: 6.7cm of den. IAL +, IPN -. Free margins. Lymph nodes 24 + / 55. Laboratory tests (11/29/18): DHL: 533U / L, a-fetus Protein: 4.13ng / ml, β-HCG: 2.39mIU / ml, TGO: 177U / L, TGP: 325U / L, GGT: 367U / L, FA: 150U / L. Adjuvant chemotherapy not indicated due to liver enzyme changes Discussion: Presentation as a primary stomach tumor is extremely rare. Germ cells are pluripotent and give rise to embryonic and extra-embryonic tissues. In the fourth embryonic week germ cells migrate from the yolk sac toward the posterior wall of the primitive intestine to the genital crest. If, for reasons not yet known, cells do not complete migration, usually near the midline, they may lead to tumors in extragonadal areas. Final comments: These tumors exhibit a complex histological picture. This case was initially diagnosed as gastric adenocarcinoma. Careful immunohistochemical analysis is vital for its diagnosis.
No conflict of interest has been declared by the author(s).
Contato:
Publication History
Article published online:
23 October 2019
© 2019. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
Gabriel da Rocha Bonatto, Diego Burgardt, Lidio Carvalho da Silva Lima, Max Wellington Satiro Justino, Paulo Victor Fortes Sampaio, Durval Renato Wohnrath, ênio David Mente, Fernando Ernesto Cruz Felippe, Marcos Aurélio Sanctis. GASTRIC ENDODERMIC TUMOR. Brazilian Journal of Oncology 2019; 15.
DOI: 10.1055/s-0044-1797806