title: Fever as a first manifestation of advanced gastric adenosquamous carcinoma: a case report.
abstract: Gastric adenosquamous carcinoma (ASC) is a rare type of gastric cancer. It is a mixed neoplasm, consisting of glandular cells and squamous cells. It is often diagnosed at an advanced stage, thus carrying a poor prognosis. We describe a case of a 73-year-old male, who presented with refractory fever and an intra-abdominal mass on imaging. He underwent a laparoscopic exploration followed by a successful totally laparoscopic total gastrectomy with D2 lymphadenectomy for gastric cancer. Postoperative pathology revealed primary gastric ASC (T4aN0M0). The patient received adjuvant radiotherapy and chemotherapy with S1 and is alive 20 mo after surgery without recurrence. This is the first case of advanced gastric ASC with fever as the initial presentation treated with totally laparoscopic total gastrectomy reported in the English literature.
authors.affiliation: Harsha Ajoodhea, Ren-Chao Zhang, Xiao-Wu Xu, Wei-Wei Jin, Ke Chen, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Harsha
authors.initials: H
authors.lastname: Ajoodhea
authors.affiliation: Harsha Ajoodhea, Ren-Chao Zhang, Xiao-Wu Xu, Wei-Wei Jin, Ke Chen, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Ren-Chao
authors.initials: RC
authors.lastname: Zhang
authors.affiliation: Harsha Ajoodhea, Ren-Chao Zhang, Xiao-Wu Xu, Wei-Wei Jin, Ke Chen, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Xiao-Wu
authors.initials: XW
authors.lastname: Xu
authors.affiliation: Harsha Ajoodhea, Ren-Chao Zhang, Xiao-Wu Xu, Wei-Wei Jin, Ke Chen, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Jin
authors.affiliation: Harsha Ajoodhea, Ren-Chao Zhang, Xiao-Wu Xu, Wei-Wei Jin, Ke Chen, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Chen
authors.affiliation: Harsha Ajoodhea, Ren-Chao Zhang, Xiao-Wu Xu, Wei-Wei Jin, Ke Chen, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Yong-Tao
authors.initials: YT
authors.lastname: He
authors.affiliation: Harsha Ajoodhea, Ren-Chao Zhang, Xiao-Wu Xu, Wei-Wei Jin, Ke Chen, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Mou
mesh_terms: D000368:Aged; D001706:Biopsy; D018196:Carcinoma, Adenosquamous / Q000150:complications* / Q000473:pathology / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant; D005334:Fever / Q000209:etiology*; D005743:Gastrectomy / Q000379:methods; D005773:Gastroscopy; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Advanced gastric cancer; Gastric adenosquamous carcinoma; Laparoscopic gastrectomy; Malignant tumor; Totally laparoscopic total gastrectomy
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