title: A case of primary gastric undifferentiated high-grade pleomorphic sarcoma diagnosed with chief complaint of fever: a case report and literature review.
abstract: BACKGROUND
  Undifferentiated high-grade pleomorphic sarcoma in gastrointestinal tract is extremely rare, and its prognosis is poor.
  
  
  METHODS
  An 82-year-old man visited a previous hospital complaining of fever, general fatigue, and shaking chill, for which he received antibiotics therapy. As the fever continued, he was referred to our hospital, where computed tomography and upper gastrointestinal endoscopy showed a 6-cm gastric tumor. A preoperative biopsy was consistent with a malignant mesenchymal tumor, but could not provide a definitive pathological diagnosis nor prove a cause-and-effect relationship between the chief complaint and the gastric tumor. The gastric tumor had grown to 8 cm in diameter within a month so we performed a partial gastrectomy. The pathological postoperative diagnosis was undifferentiated high-grade pleomorphic sarcoma that produced granulocyte colony-stimulating factor. The patient's fever quickly improved, and he showed a good postoperative course.
  
  
  CONCLUSIONS
  We herein report a case of rapidly growing, undifferentiated, high-grade pleomorphic gastric sarcoma, which presented as a chief complaint of fever.
authors.affiliation: Department of Surgery, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan. akaba@munakata-med-hp.gr.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Kabashima
authors.affiliation: Department of Surgery, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Surgery, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan.
authors.forename: Kensaku
authors.initials: K
authors.lastname: Sanefuji
authors.affiliation: Department of Radiology, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Masunari
authors.affiliation: Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, 818-0067, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Haraoka
authors.affiliation: Department of Surgery, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Maekawa
keywords: Fever; Granulocyte colony-stimulating factor (G-CSF); Stomach; Undifferentiated high-grade pleomorphic sarcoma