title: Postsurgical radiation therapy for gastric carcinosarcoma with c-kit expression: a case report.
abstract: Gastric carcinosarcomas are rare morphologically biphasic tumors, consisting of carcinoma and sarcoma components, with a poor clinical course. Here we report the case of a 70-year-old man with advanced Borrmann type III carcinosarcoma arising from the upper body of the stomach with extensive lymph node metastasis who underwent a total, but palliative, gastrectomy. Histology showed the tumor consisted of a biphasic structure of tubular adenocarcinoma and spindle cell sarcoma. Immunohistochemistry revealed sarcoma cells expressing c-kit (CD117) and CD34, which are criteria for gastrointestinal stromal tumors. Nine months after the surgical operation, tumor metastases had extended to the hepatohilar, retroperitoneal and mediastinal lymph nodes. Radiation therapy of 50 Gy markedly decreased the size of each of these nodes and reduced the risk of respiratory complications and jaundice. However, the patient died of respiratory failure due to bronchopneumonia with multiple lung metastases 22 mo after resection. Autopsy revealed severe necrosis in most of the lymph nodes with tumor metastases. Radiation therapy combined with gastrectomy should be considered to improve survival in patients with gastric carcinosarcomas that express c-kit.
authors.affiliation: Takeshi Gohongi, Hiroyuki Iida, Naoto Gunji, Kazuo Orii, Takesaburo Ogata, Department of Surgery and Pathology, Tsukuba-Gakuen Hospital, Ibaraki 305-0857, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Gohongi
authors.affiliation: Takeshi Gohongi, Hiroyuki Iida, Naoto Gunji, Kazuo Orii, Takesaburo Ogata, Department of Surgery and Pathology, Tsukuba-Gakuen Hospital, Ibaraki 305-0857, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Iida
authors.affiliation: Takeshi Gohongi, Hiroyuki Iida, Naoto Gunji, Kazuo Orii, Takesaburo Ogata, Department of Surgery and Pathology, Tsukuba-Gakuen Hospital, Ibaraki 305-0857, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Gunji
authors.affiliation: Takeshi Gohongi, Hiroyuki Iida, Naoto Gunji, Kazuo Orii, Takesaburo Ogata, Department of Surgery and Pathology, Tsukuba-Gakuen Hospital, Ibaraki 305-0857, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Orii
authors.affiliation: Takeshi Gohongi, Hiroyuki Iida, Naoto Gunji, Kazuo Orii, Takesaburo Ogata, Department of Surgery and Pathology, Tsukuba-Gakuen Hospital, Ibaraki 305-0857, Japan.
authors.forename: Takesaburo
authors.initials: T
authors.lastname: Ogata
mesh_terms: D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D002296:Carcinosarcoma / Q000737:chemistry / Q000556:secondary / Q000628:therapy*; D017809:Fatal Outcome; D005743:Gastrectomy; D005773:Gastroscopy; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis*; D011829:Radiation Dosage; D018714:Radiotherapy, Adjuvant; D013274:Stomach Neoplasms / Q000737:chemistry / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D019009:Proto-Oncogene Proteins c-kit
keywords: C-kit; CD34; Gastric carcinosarcoma; Gastrointestinal stromal tumor; Radiation therapy