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Miki K, Yoshimoto K, Yamada Y, Kabashima A, Kuga D, Oda Y, Iihara K. Rapid growth of metastatic brain tumor from gastric undifferentiated pleomorphic sarcoma: A case report. Surg Neurol Int 2019; 10:74. [PMID: 31528412 PMCID: PMC6744778 DOI: 10.25259/sni-84-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/07/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Brain metastasis from undifferentiated pleomorphic sarcoma (UPS) is a rare occurrence, and its clinical course is little known. In this report, we investigate a case of a rapidly growing brain metastasis from gastric UPS. Case Description: An 82-year-old man with a known gastric tumor, pathologically compatible with UPS, underwent partial gastrectomy at an outside facility. 3 months later, a 4-cm brain tumor was detected, which was completely resected. The patient was diagnosed with metastatic tumor from previously treated gastric UPS. Within 2 months of the initial resection, a large recurrent mass was detected in the same location, which was again removed. Although the patient underwent radiotherapy and chemotherapy for other metastatic tumors, he died 5 months after the second craniotomy. Conclusions: Brain metastasis from gastric UPS is rare and difficult to treat. Although aggressive treatment, such as surgical intervention, may improve patient survival in some cases, the timing of treatment is challenging because cerebral metastasis rapidly grows and and patients frequently suffer from synchronous systematic metastasis. Therefore, early detection and close follow-up of rapidly progressing brain metastasis are important to improve treatment outcomes.
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Affiliation(s)
- Kenji Miki
- Department of Neurosurgery, Aso Iizuka hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka.,Department of Neurosurgery, Aso Iizuka hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka
| | - Koji Yoshimoto
- Department of Neurosurgery, Aso Iizuka hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka.,Department of Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima
| | - Yuichi Yamada
- Department of Pathology, Graduate School of Medical Sciences, Kyushu University
| | | | - Daisuke Kuga
- Department of Neurosurgery, Aso Iizuka hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka
| | - Yoshinao Oda
- Department of Pathology, Graduate School of Medical Sciences, Kyushu University
| | - Koji Iihara
- Department of Neurosurgery, Aso Iizuka hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka
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Oguri Y, Cho H, Oohinata R, Onoyama H, Takada R, Motoi T. Aggressive undifferentiated pleomorphic sarcoma of the stomach involving long-term survival: A case report and literature review. Mol Clin Oncol 2018; 9:661-665. [PMID: 30546898 DOI: 10.3892/mco.2018.1739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022] Open
Abstract
Primary gastric undifferentiated pleomorphic sarcoma (UPS) is a rare disease with insufficient long-term follow-up data. In the present study, a 70-year-old male complained of abdominal fullness and visited our hospital. Abdominal computed tomography revealed a large tumor in the upper part of the stomach, which was accompanied by smaller tumors in the small intestinal mesentery. An endoscopic ultrasound-guided fine-needle biopsy examination of the gastric tumor revealed features of pleomorphic sarcoma and high-grade spindle-shaped cells. Total gastrectomy was performed on the primary tumor, together with combined resection of the small intestine for the metastatic tumors. However, the tumor recurred in the mesentery of the sigmoid colon 6 months after the operation. A second operation was performed to resect the recurrent tumor. Since the second surgical procedure, the patient has remained free from recurrence for >7 years. Although the prognosis of abdominal UPS was considered to be poor, even after curative surgery, the present case experienced a long-term survival of gastric UPS after undergoing surgical resection alone.
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Affiliation(s)
- Yohei Oguri
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, Japan
| | - Haruhiko Cho
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, Japan
| | - Ryouki Oohinata
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, Japan
| | - Haruna Onoyama
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, Japan
| | - Ryosuke Takada
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, Japan
| | - Toru Motoi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-0021, Japan
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Kabashima A, Kimura K, Sanefuji K, Masunari S, Haraoka S, Maekawa S. A case of primary gastric undifferentiated high-grade pleomorphic sarcoma diagnosed with chief complaint of fever: a case report and literature review. Surg Case Rep 2017; 3:41. [PMID: 28276003 PMCID: PMC5342989 DOI: 10.1186/s40792-017-0317-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Undifferentiated high-grade pleomorphic sarcoma in gastrointestinal tract is extremely rare, and its prognosis is poor. CASE PRESENTATION 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.
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Affiliation(s)
- Akira Kabashima
- Department of Surgery, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan.
| | - Koichi Kimura
- Department of Surgery, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan
| | - Kensaku Sanefuji
- Department of Surgery, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan
| | - Satoru Masunari
- Department of Radiology, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan
| | - Seiji Haraoka
- Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, 818-0067, Japan
| | - Soichiro Maekawa
- Department of Surgery, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan
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Wiersema AM, Wobbes T, Pruszczynski M, van der Sluis RF. Malignant fibrous histiocytoma of the stomach during pregnancy: a case report. Eur J Obstet Gynecol Reprod Biol 1998; 80:71-3. [PMID: 9758263 DOI: 10.1016/s0301-2115(98)00089-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In this case report we describe a patient with a primary malignant fibrous histiocytoma of the stomach, diagnosed and operated upon during the sixth month of pregnancy. We stress the importance of a thorough diagnostic examination in cases of severe anaemia during pregnancy. Although very rare, malignancy of the gastrointestinal tract should be taken in consideration. No holding back is justified in diagnostic and therapeutic measurements because of pregnancy. Radiologic examination of the gastrointestinal tract should be replaced by endoscopy.
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Affiliation(s)
- A M Wiersema
- Department of Surgery, University Hospital Nijmegen, The Netherlands
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Wada Y, Matsushita T, Sarumaru S, Ryo J, Isobe H, Satoh B, Kanaya S, Katayama T, Ohtoshi M. Malignant fibrous histiocytoma of the stomach: report of two cases. Surg Today 1998; 28:296-300. [PMID: 9548313 DOI: 10.1007/s005950050125] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Malignant fibrous histiocytoma (MFH) in the stomach is very rare, and only four cases have been reported. As a result, there is still little understanding of its clinical and pathological features. We recently experienced two cases of gastric MFH. The first case was a 78-year-old man with epigastralgia and a loss of body weight. Endoscopy revealed an ulcerated submucosal tumor. A gastrectomy was performed and the diagnosis of MFH was made histopathologically. The second case was a 77-year-old man with pulmonary symptoms. An image diagnosis indicated a strong suspicion of lung cancer, and a right middle and lower lobectomy was thus performed. One month after the operation, a bleeding gastric tumor was found and therefore a gastrectomy was performed. Both tumors were diagnosed as MFH. From the analysis of six reported cases including ours, a preoperative correct diagnosis is found to be difficult although the lesion has grown to a considerable size at the time of operation. Since a metastatic lung lesion was first detected in two out of six cases, it is thus recommended that the stomach should be examined when lung MFH is found. Considering the high mortality and the short survival in the six cases, the prognosis for gastric MFH seems to be poorer than that in the extremities. However, lymph node metastasis is uncommon, and a curative resection is possible in some cases such as in our second case.
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Affiliation(s)
- Y Wada
- Department of Surgery, Himeji National Hospital, Hyogo, Japan
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Murata I, Makiyama K, Miyazaki K, Kawamoto AS, Yoshida N, Muta K, Itsuno M, Hara K, Nakagoe T, Tomita M. A case of inflammatory malignant fibrous histiocytoma of the colon. GASTROENTEROLOGIA JAPONICA 1993; 28:554-63. [PMID: 7690726 DOI: 10.1007/bf02776955] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Primary malignant fibrous histiocytoma seldom occurs in the alimentary tract. This report documents a case in which a 50-year-old man presented with abdominal fullness and anorexia, together with inflammatory reactions such as fever, leukocytosis, an elevated erythrocyte sedimentation rate and positive CRP. Radiologic and endoscopic studies revealed a large mass in the ascending colon. The histology of the resected tumor revealed inflammatory malignant fibrous histiocytoma, a histologic subtype which is rare among not only soft tissue fibrous but also as gastrointestinal histiocytomas. The inflammatory reactions disappeared following resection of the tumor. Although we suspected that the tumor produced granulocyte colony-stimulating factor because of the slightly elevated serum level and the characteristics of the tumor histology, an immunohistochemical study failed to show the G-CSF production by the tumor cells.
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Affiliation(s)
- I Murata
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan
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