Gastric adenocarcinoma at stage IV with complete remission after neoadjuvant therapy concurrent with adenosquamous carcinoma of the ampulla of Vater: a case report and literature review

Abstract Background Adenosquamous carcinoma (ASC) of the ampulla of Vater (AmV) is exceedingly rare with more aggressive behavior and worse prognosis than adenocarcinoma. The finding of ASC at the AmV in combination to the gastric adenocarcinoma has never been reported in the literature before. Case presentation An old lady was diagnosed as gastric adenocarcinoma at stage IV with enlargement of supraclavicular lymph nodes by gastroscopy and histopathological evaluation 3 years ago. Afterwards, the patient achieved complete remission after regular chemotherapy. However, the patient manifested yellow sclera and skin, choluria and clay colored stool 3 months ago. Preoperative contrast-enhanced CT, ERCP, MRCP, and PET/CT revealed the presence of an ampullary tumor. The patient then underwent laparoscopic radical gastrectomy and pancreaticoduodenectomy with regional lymph node dissection. Postoperative cytological analyses confirmed the diagnosis of gastric ulcer with complete response to neoadjuvant therapy and ASC at the AmV. The patient’s postoperative outcome was uneventful. Conclusion Drawing firm conclusions about the diagnosis of ampullary ASC is difficult because of the difficulty in acquiring both adenocarcinoma and SCC components by fine needle biopsy. The rarity of ASC of the AmV coexistent with gastric carcinoma makes it difficult to elucidate their clinicopathological characteristics, therapeutic strategies and overall prognosis. Surgical resection still remains the main treatment method.

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Metachronous early gastric adenocarcinoma presenting coinstantaneously with complete remission of stage IV gastric MALT lymphoma

Arab Journal of Gastroenterology ◽

10.1016/j.ajg.2013.01.004 ◽

2013 ◽

Vol 14 (1) ◽

pp. 20-23 ◽

Cited By ~ 3

Author(s):

Orestis Ioannidis ◽

Argiro Sekouli ◽

George Paraskevas ◽

Nikolaos Papadimitriou ◽

Athina Konstantara ◽

...

Keyword(s):

Complete Remission ◽

Gastric Adenocarcinoma ◽

Malt Lymphoma ◽

Stage Iv ◽

Gastric Malt Lymphoma

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Curative treatment in a patient with gastric cancer stage IV: a case report

F1000Research ◽

10.12688/f1000research.1-34.v1 ◽

2012 ◽

Vol 1 ◽

pp. 34

Author(s):

Andreas Diel ◽

Ernst Rodermann ◽

Hans-Friedrich Kienzle ◽

Denis Meuthen ◽

Ingo Meuthen

Keyword(s):

Gastric Cancer ◽

Case Report ◽

Complete Remission ◽

Partial Response ◽

Gastric Adenocarcinoma ◽

Stage Iv ◽

Complete Resection ◽

Cancer Stage ◽

Third Line ◽

Line Chemotherapy

A 39-year old patient with gastric adenocarcinoma stage IV failed to respond to preoperative chemotherapies containing 5-FU and cisplatin as well as 5-FU and irinotecan. After third-line chemotherapy with two cycles of docetaxel and cisplatin we confirmed a clinical partial response. A complete histologically confirmed remission was detected after complete resection of the tumor. Following two postoperative cycles of docetaxel and cisplatin, the tumor is still in complete remission after more than eight years.

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SHR-1210 Combined With Trastuzumab , Oxaliplatin and Capecitabine for Neoadjuvant Therapy of Gastric Adenocarcinoma/Gastroesophageal Junction Adenocarcinoma

Case Medical Research ◽

10.31525/ct1-nct03950271 ◽

2019 ◽

Author(s):

Keyword(s):

Neoadjuvant Therapy ◽

Gastric Adenocarcinoma ◽

Gastroesophageal Junction ◽

Gastroesophageal Junction Adenocarcinoma

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Complete remission of stage IV erythrodermic mycosis fungoides with large cell transformation through combination of pralatrexate and romidepsin followed by allogeneic hematopoietic stem cell transplantation

Australasian Journal of Dermatology ◽

10.1111/ajd.13606 ◽

2021 ◽

Author(s):

Aaron J Frederiks ◽

Katherine J Creeper ◽

Dominic V Spagnolo ◽

Paul Cannell ◽

Dejan Radeski

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Complete Remission ◽

Stem Cell Transplantation ◽

Mycosis Fungoides ◽

Cell Transformation ◽

Stage Iv ◽

Large Cell ◽

Hematopoietic Stem ◽

Large Cell Transformation

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18F-FDG PET/CT versus Diagnostic Contrast-Enhanced CT for Follow-Up of Stage IV Melanoma Patients Treated by Immune Checkpoint Inhibitors: Frequency and Management of Discordances over a 3-Year Period in a University Hospital

Diagnostics ◽

10.3390/diagnostics11071198 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1198

Author(s):

Jean-Baptiste Le Goubey ◽

Charline Lasnon ◽

Ines Nakouri ◽

Laure Césaire ◽

Michel de Pontville ◽

...

Keyword(s):

Fdg Pet ◽

Stage Iv ◽

Anatomical Site ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Induced Changes

Aim: To perform a comprehensive analysis of discordances between contrast-enhanced CT (ceCT) and 18F-FDG PET/CT in the evaluation of the extra-cerebral treatment monitoring in patients with stage IV melanoma. Materials and methods: We conducted a retrospective monocentric observational study over a 3-year period in patients referred for 18F-FDG PET/CT and ceCT in the framework of therapy monitoring of immune checkpoint (ICIs) as of January 2017. Imaging reports were analyzed by two physicians in consensus. The anatomical site responsible for discordances, as well as induced changes in treatment were noted. Results: Eighty patients were included and 195 pairs of scans analyzed. Overall, discordances occurred in 65 cases (33%). Eighty percent of the discordances (52/65) were due to 18F-FDG PET/CT scans upstaging the patient. Amongst these discordances, 17/52 (33%) led to change in patient’s management, the most frequent being radiotherapy of a progressing site. ceCT represented 13/65 (20%) of discordances and induced changes in patients’ management in 2/13 cases (15%). The most frequent anatomical site involved was subcutaneous for 18F-FDG PET/CT findings and lung or liver for ceCT. Conclusions: Treatment monitoring with 18F-FDG PET/CT is more efficient than ceCT and has a greater impact in patient’s management.

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Network pharmacology dissection of multiscale mechanisms of herbal medicines in stage IV gastric adenocarcinoma treatment

Medicine ◽

10.1097/md.0000000000004389 ◽

2016 ◽

Vol 95 (35) ◽

pp. e4389 ◽

Cited By ~ 12

Author(s):

Li Gao ◽

Jian Hao ◽

Yang-Yang Niu ◽

Miao Tian ◽

Xue Yang ◽

...

Keyword(s):

Gastric Adenocarcinoma ◽

Herbal Medicines ◽

Stage Iv ◽

Network Pharmacology

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A Case of Long-Term Complete Remission of Advanced Gastric Adenocarcinoma with Liver Metastasis

Journal of Gastric Cancer ◽

10.5230/jgc.2016.16.2.115 ◽

2016 ◽

Vol 16 (2) ◽

pp. 115 ◽

Cited By ~ 1

Author(s):

Ch'angbum Rim ◽

Jung-Ae Lee ◽

Soojung Gong ◽

Dong Wook Kang ◽

Heebum Yang ◽

...

Keyword(s):

Liver Metastasis ◽

Complete Remission ◽

Gastric Adenocarcinoma ◽

Advanced Gastric Adenocarcinoma

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Her2+ and b-HCG Producing Undifferentiated Gastric Adenocarcinoma

Case Reports in Medicine ◽

10.1155/2014/268919 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5

Author(s):

Sahar Eivaz-Mohammadi ◽

Fernando Gonzalez-Ibarra ◽

Waheed Abdul ◽

Omer Tarar ◽

Khurram Malik ◽

...

Keyword(s):

Gastric Adenocarcinoma ◽

Stage Iv ◽

Stomach Body ◽

Ct Angiogram ◽

Lytic Lesions ◽

Night Sweats ◽

History Of ◽

Stomach Fundus ◽

Poorly Differentiated ◽

Lesser Curvature

A 25-year-old Hispanic female with a history of anemia, schizoaffective disorder, and psychosis was admitted for anemia associated with fatigue, weakness, shortness of breath, night sweats, weight loss, and abdominal and lower back pain for the past two months. On routine management, she was found to have a positive serum b-HCG of 80.4 (0–5 mIU/mL) but the patient denied any sexual activity in her life. During her admission, U/S of the pelvis was noncontributory. CT angiogram of the chest was significant for prominent mediastinal and hilar lymph nodes, diffusely thickened stomach suggesting gastric malignancy with multiple hypoenhancing lesions in the liver and diffuse lytic lesions in the spine and sacrum suspicious for metastatic disease. The MRI of the abdomen confirmed the CT angiogram findings. After these findings, EGD was performed which showed lesions in the antrum, body of the stomach, fundus, and cardia on the lesser curvature of the stomach body correlating with carcinoma. The biopsy was positive for Her2, b-HCG producing poorly differentiated gastric adenocarcinoma. Patient underwent one successful round of chemotherapy with Taxotene, Cisplatin, and 5-FU for Stage IV gastric adenocarcinoma.

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