title: Gastric Ewing sarcoma/primitive neuroectodermal tumor: A case report.
abstract: Ewing sarcoma/primitive neuroectodermal tumors (ES/PNETs) may arise in bone or soft tissue; however, these tumors rarely originate in the stomach. To the best of our knowledge, only four cases have previously been reported in the English-language literature. A 41-year-old Japanese woman was admitted with abdominal pain and underwent gastrectomy to remove the primary tumor. Immunohistochemistry, chromosomal karyotype and molecular analysis using reverse transcription-polymerase chain reaction were performed in the tumor specimens obtained. Tumor cells showed positive immunoreactivity for CD99, vimentin, CD117 (c-kit), S100, chromogranin A and synaptophysin. The tumor was a gastric ES/PNET with the EWS-FLI1 fusion gene translocation t(11;22)(q24;q12). Multiple repeat metastasectomies, as well as multi-agent chemotherapy and radiotherapy were performed for recurrent disease. Despite treatment, the patient succumbed due to progressive disease 110 months after the initial surgery for gastric ES/PNET. A review of the reported cases suggests that patients with gastric ES/PNETs have an unfavorable prognosis following resection due to the high propensity of these tumors to metastasize. Thus, multimodal treatment approaches including surgery, as well as multi-agent chemotherapy and radiotherapy may provide a survival benefit for patients with gastric ES/PNETs.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata 951-8510, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Inoue
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Wakai
authors.forename: Pavel V
authors.initials: PV
authors.lastname: Korita
authors.forename: Jun
authors.initials: J
authors.lastname: Sakata
authors.forename: Ryo
authors.initials: R
authors.lastname: Kurosaki
authors.forename: Akira
authors.initials: A
authors.lastname: Ogose
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawashima
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Shirai
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ajioka
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama