Gastric amphicrine carcinoma with leptomeningeal metastases: A case report

doi:10.4251/wjgo.122768

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Sep 15, 2026; 18(9): 122768
Published online Sep 15, 2026. doi: 10.4251/wjgo.122768

Gastric amphicrine carcinoma with leptomeningeal metastases: A case report

Chao Deng, Yan-Fen Shi, Wen-Juan Guo, Chao Wang, Dong-Mei Chen, Huang-Ying Tan

Chao Deng, Chao Wang, Dong-Mei Chen, Huang-Ying Tan, Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, China

Yan-Fen Shi, Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, China

Wen-Juan Guo, Department of Gastroenterology, China-Japan Friendship Hospital, Beijing 100029, China

Co-first authors: Chao Deng and Yan-Fen Shi.

Author contributions: Deng C and Shi YF equally contributed to this report as co-first authors; Deng C drafted the manuscript; Tan HY proposed the concept of this case report; Shi YF contributed to the description and analyses of the pathological findings; Guo WJ contributed to the analyses of the gastroscopy images; Deng C, Wang C, and Chen DM contributed to the data collection for this report; Tan HY, Deng C , Wang C, and Chen DM administered the entire course of diagnosis and treatment in this patient; All authors contributed to the article and approved the submitted version.

AI contribution statement: During the preparation of this manuscript, the authors used DeepSeek (developed by DeepSeek AI) for partial language polishing and grammar improvement. After its use, the authors thoroughly reviewed, verified, and revised all AI-assisted content to ensure accuracy and originality. The authors assume full responsibility for the integrity, accuracy, and originality of the manuscript.

Supported by National High Level Hospital Clinical Research Funding, No. 2025-NHLHCRF-PY-11; Elite Medical Professionals Project of China-Japan Friendship Hospital, No. ZRJY2023-GG01; and Remaining Funds of the National Natural Science Foundation of China, No. 2026-GZRJY-02.

Informed consent statement: Written informed consent was obtained from the patient for the publication of any potentially identiﬁable images or data included in this article.

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

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: Huang-Ying Tan, MD, PhD, Professor, Department of Integrative Oncology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing 100029, China. tanhuangying@zryhyy.com.cn

Received: April 28, 2026
Revised: June 4, 2026
Accepted: June 22, 2026
Published online: September 15, 2026
Processing time: 120 Days and 15.1 Hours

Abstract

BACKGROUND

Amphicrine carcinoma (AC) is a rare tumor characterized by the coexistence of exocrine and neuroendocrine differentiation within the same cell. Leptomeningeal metastasis (LM) is likewise an uncommon occurrence in gastric cancer. We report the first documented case of advanced gastric AC with LM.

CASE SUMMARY

The patient was a 66-year-old man who presented with progressively worsening abdominal pain, along with acid reflux, belching, nausea, and melena. Imaging studies revealed a malignant mass in the gastric antrum with multiple lymph node and hepatic metastases. Gastroscopy demonstrated a large ulcerative lesion in the gastric antrum. Biopsies were sequentially obtained from the primary gastric tumor and the liver metastasis. Pathological evaluation consistently revealed a single population of tumor cells co-expressing adenocarcinoma (mucin 1 [MUC-1], MUC-2, D-PAS) and neuroendocrine markers (chromogranin A, synaptophysin [Syn], insulinoma-associated protein 1), supporting the diagnosis of AC. Treatment was administered according to standard gastric adenocarcinoma protocols. The treatment outcomes demonstrated that progression-free survival ranged only from approximately 1.6 months to 5 months in the following three lines of treatments, with an overall survival of 10 months. One week prior to the patient’s death, cerebrospinal fluid (CSF) biopsy was performed following an episode of generalized (grand mal) epilepsy. The detection of carcinoma cells in the CSF confirmed the presence of LM.

CONCLUSION

Accurate diagnosis of gastric AC is challenging, as it requires concurrent immunohistochemical staining for both epithelial mucin markers and neuroendocrine-associated markers. Currently, no standard treatment protocol has been established. Both gastric AC and the development of LM are associated with a poor prognosis.

Keywords: Gastric carcinoma; Neuroendocrine neoplasm; Amphicrine carcinoma; Hepatic metastasis; Leptomeningeal metastasis; Case report

Core Tip: Based on histopathological findings from both the primary tumor and metastatic site, this case was diagnosed as advanced gastric amphicrine carcinoma. The patient underwent multiple lines of therapy, along with serial imaging and endoscopic evaluations. Nevertheless, the tumor did not respond well to treatment regimens typically used for conventional adenocarcinoma. In the end, the patient died from a rare leptomeningeal metastasis, indicating an unfavorable prognosis.