Poorly Differenciated Medullary Carcinoma of the Stomach; Case Report

Yıl 2010, Cilt: 2 Sayı: 1, 27 - 30, 01.04.2010

Ahmet Midi Çiğdem Ataizi Çelikel Funda Tanay Eren

Öz

Medullary carcinoma of the stomach is a rare tumor with an appearance similar to a poorly differentiated carcinoma but its behavior is similar to well differentiated gastric carcinoma. Our case is 82 years old male patient. Endoscopic biopsy was reported as an intestinal type adenocarcinoma. In the subtotal gastrectomy specimen at the posterior wall of the antrum and small curvature localizations an ulceroinfi ltrative tumor with 6.5 cm diameter in size was found. Histopathological examinations showed that the tumor composed of thicker trabecular structure. The tumor cells were monomorphic with atypical appearance having bigger lymphocytes, indistinct cytoplasm and partially distinct nucleolus. Case was presented because of medullary carcinoma of the stomach is a rare tumor and endoscopic biopsies constitute diagnostic difficulty.

Anahtar Kelimeler

stomach, medullary carcinoma, diffuse type

Midenin Kötü Differansiye Medüller Karsinomu: Olgu Sunumu

Öz

Mide'nin medüller karsinomu morfolojik açıdan kötü farklılaşma gösteren mide karsinomları arasında incelenmesine karşın biyolojik davranışı midenin iyi farklılaşma gösteren karsinomlarına benzeyen nadir görülen bir tümördür. Olgumuz 82 yaşında erkek hastadır. Endoskopik biyopsisi intestinal tip adenokarsinom tanısı almıştır. Subtotal gastrektomi spesmeninde antrumda posterior duvar, küçük kurvatur yerleşimli 6.5 cm çapta ülseroinfiltratif tümör saptanmıştır. Histopatolojik incelemede kalın trabeküler yapılar oluşturan lenfositten iri, yer yer belirgin nükleollü, sitoplâzmaları net olarak seçilemeyen, monomorfik, atipik hücrelerin oluşturduğu tümör izlenmiştir. Olgu mide medüller karsinomunun nadir görülmesi ve endoskopik biyopsilerde tanı güçlüğü oluşturması nedeniyle sunulmuştur.

Anahtar Kelimeler

mide, medüller karsinom, diffüz tip

Kaynakça

• Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carci- noma. Acta Pathol Microbiol Scand 1965; 64:31-49.
• Ming SC. Gastric carcinoma: a pathological clas- siŞ cation. Cancer 1977; 39: 2475-85.
• Sugano H, Nakamura K, Kato Y. Pathological stu- dies of human gastric cancer.Acta Pathol Jpn. 1982;32 Suppl 2:329-47.
• Adachi Y, Yasuda K, İnomata M, Sato K, Shiraishi N, Kitano S. Pathology and prognosis of the gastric carcinoma well versus poorly differantiated type. Cancer 2000; 89:1418-24.
• Rodriguez A, Cejas HA, Martínez M, Cabral C. [Medullary carcinoma of the stomach] Rev Fac Cien Med Univ Nac Cordoba. 2000;57: 59- 65
• Takano Y, Kato Y. Epstein- Barr virus association with early cancers found together with gastric medul- lary carcinomas demonstrating lymphoid inŞ ltration. J Pathol 1995; 175:39-44.
• Takano Y, Kato Y, Sugano H. Epstein- Barr virus- associated medullary carcinoma with lymphoid inŞ l- tration of the stomach. J Cancer Res Clin Oncol 1994; 120:303-308.
• Umedo T,Sakamoto J, Watanabe T, Ito K, Akimaya S, Yasue M, Takagi H. İmmunohistocemical analysis of the poorly differantiated stomach adenocarcinoma with medullary growth pattern. J Surg Oncol 1996; 62:34-39.
• Otsuji E, Kuriu Y, Ichikawa D, Ochiai T, Okamoto K, Hagiwara A, Yamagishi H. Clinicopathologic and prognostic characterization of poorly differentiated medullary-type gastric adenocarcinoma. World J Surg. 2004; 28:862-865.