Gao CZ, Meng Y, Du JZ, Zhu X. Very-early-stage gastric amphicrine carcinoma with mixed histology: A case report and review of literature. World J Gastroenterol 2025; 31(44): 112187 [PMID: 41356518 DOI: 10.3748/wjg.v31.i44.112187]
Corresponding Author of This Article
Xu Zhu, Department of Endoscopy, Fushun Central Hospital, No. 5 Xincheng Road, Shuncheng District, Fushun 113006, Liaoning Province, China. zhuxfushun@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
case-report
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Gao CZ, Meng Y, Du JZ, Zhu X. Very-early-stage gastric amphicrine carcinoma with mixed histology: A case report and review of literature. World J Gastroenterol 2025; 31(44): 112187 [PMID: 41356518 DOI: 10.3748/wjg.v31.i44.112187]
World J Gastroenterol. Nov 28, 2025; 31(44): 112187 Published online Nov 28, 2025. doi: 10.3748/wjg.v31.i44.112187
Very-early-stage gastric amphicrine carcinoma with mixed histology: A case report and review of literature
Cai-Zhi Gao, Yuan Meng, Jin-Zhu Du, Xu Zhu
Cai-Zhi Gao, Xu Zhu, Department of Endoscopy, Fushun Central Hospital, Fushun 113006, Liaoning Province, China
Yuan Meng, Department of Pathology, Fushun Central Hospital, Fushun 113006, Liaoning Province, China
Jin-Zhu Du, Department of General Surgery, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032, Liaoning Province, China
Co-corresponding authors: Jin-Zhu Du and Xu Zhu.
Author contributions: Gao CZ contributed to the manuscript writing and editing, and data collection; Meng Y contributed to conceptualization and supervision; Du JZ and Zhu X contributed equally to revising the article and supervision, and they are co-corresponding authors of this manuscript. All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Xu Zhu, Department of Endoscopy, Fushun Central Hospital, No. 5 Xincheng Road, Shuncheng District, Fushun 113006, Liaoning Province, China. zhuxfushun@163.com
Received: July 30, 2025 Revised: September 10, 2025 Accepted: October 20, 2025 Published online: November 28, 2025 Processing time: 125 Days and 11.2 Hours
Abstract
BACKGROUND
Amphicrine carcinoma is an extremely rare entity. In this article, we report the first known case of very-early-stage amphicrine carcinoma characterized by a mixed growth pattern with multiple pathological components.
CASE SUMMARY
A 59-year-old male patient underwent gastroscopy for abdominal discomfort, which revealed a 1.5 cm elevated lesion on the lower part of the anterior aspect of the gastric body close to the gastric angle. Initial biopsy indicated signet-ring cell carcinoma (SRCC) confined to the mucosa. Following endoscopic submucosal dissection, pathological examination revealed signet-ring cells arranged in both nested clusters and diffuse infiltration demonstrating immunohistochemical positivity for periodic acid-Schiff staining for mucin, chromogranin A, and synaptophysin. The coexistence of these endocrine and exocrine markers supported the diagnosis of amphicrine carcinoma. A mixed growth pattern comprising poorly differentiated adenocarcinoma, neuroendocrine tumor, and SRCC was identified. Whether the amphicrine carcinoma arose directly from multipotent stem cells or differentiation from signet-ring cells remains unclear.
CONCLUSION
Routine neuroendocrine immunohistochemical marker staining for SRCC may improve the diagnosis of amphicrine carcinoma and provide guidance for subsequent treatment.
Core Tip: Based on white-light endoscopy findings and biopsy pathology results, this case was initially diagnosed as pure signet-ring cell carcinoma. Subsequent narrow-band imaging magnifying endoscopy supported this diagnosis. However, post-endoscopic submucosal dissection pathology revealed a very-early-stage amphicrine carcinoma with a mixed growth pattern comprising poorly differentiated adenocarcinoma, neuroendocrine tumor, and signet-ring cell carcinoma. We subsequently re-evaluated the endoscopic manifestations of this lesion and, in conjunction with the pathological findings, proposed the endoscopic features of amphicrine carcinoma presenting with signet-ring cell morphology.
