Gastric cancer with calcifications: A case report

doi:10.12998/wjcc.v9.i27.8135

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Sep 26, 2021; 9(27): 8135-8141
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8135

Gastric cancer with calcifications: A case report

Yu-He Lin, Wei Yao, Qian Fei, Ying Wang

Yu-He Lin, Qian Fei, Ying Wang, Department of Oncology, China Medical University Affiliated Shengjing Hospital, Shenyang 110022, Liaoning Province, China

Wei Yao, Department of Surgery, China Medical University Affiliated Shengjing Hospital, Shenyang 110000, Liaoning Province, China

Author contributions: Lin YH and Yao W participated in data acquisition and analysis, literature review and article writing; Fei Q was responsible for the collection of clinical data and relevant pictures; Wang Y supervised the revision of the manuscript; All authors read and approved the final manuscript and take responsibility for the content.

Informed consent statement: The patient provided informed written consent for the publication of this case report.

Conflict-of-interest statement: The authors declare that they have no conflicting interests.

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: Yu-He Lin, MD, Attending Doctor, Department of Oncology, China Medical University Affiliated Shengjing Hospital, No. 39 Huaxiang Road, Shenyang 110022, Liaoning Province, China. linyuhe2331@163.com

Received: April 15, 2021
Peer-review started: April 15, 2021
First decision: June 15, 2021
Revised: June 20, 2021
Accepted: August 12, 2021
Article in press: August 12, 2021
Published online: September 26, 2021
Processing time: 154 Days and 1 Hours

Abstract

BACKGROUND

Mucinous gastric carcinoma (MGC) is a rare histological type of gastric carcinoma. Calcifications, seen on imaging and histopathological preparations, and which are infrequent in other types of gastric carcinoma, are characteristic of MGC. We present a patient with MGC with calcifications of the gastric wall and describe the computerized tomography (CT) features of the lesion and changes in the calcifications before and after chemotherapy.

CASE SUMMARY

A 61-year-old man was admitted to our hospital in May 2020 because of a large, tender abdominal mass. Abdominal CT showed diffuse, irregular thickening of the gastric walls, with miliary and punctate calcifications. There were metastases to the perigastric and retroperitoneal lymph nodes and also peritoneal seeding. Histological examination of a specimen obtained by endoscopic biopsy showed poorly differentiated calcified signet-ring cell gastric cancer. The patient was clinically staged with T4N+M1 disease. He was treated with docetaxel, cisplatin, and fluorouracil as first-line therapy, irinotecan combined with S-1 as second-line chemotherapy, and programmed cell death protein 1 as third-line therapy. The patient underwent a total of nine cycles of chemotherapy. Follow-up CT scans every 3 mo showed continually increasing calcifications. As of this writing, the patient has survived almost 1 year.

CONCLUSION

In this case report, we describe the histopathological and imaging characteristics of a patient with gastric cancer receiving chemotherapy. Multiple punctate calcifications were seen, which gradually increased during chemotherapy. Several possible mechanisms for the calcifications are described, but further research is needed. Future findings may lead to new approaches for the evaluation and treatment of such tumors.

Keywords: Gastric cancer; Calcification; Computerized tomography; Chemotherapy; Prognosis; Case report

Core Tip: In this report we present a case of gastric mucinous adenocarcinoma with calcification in the gastric wall on computerized tomography evaluation before and after chemotherapy. We explain not only the different theory of the calcification formation and variety, but also the relationship of calcification with prognosis. We hope the results provide new thoughts on tumor evaluation and treatment in the future.