Rare Coincidence of Gastric Cancer and Large Myofibroblastic Tumor of The Spleen

Abstract

Although its incidence has been decreasing during the last decades, gastric cancer remains a common disease and a global health problem. Conversely, inflammatory myofibroblastic tumors, especially the splenic ones, are extremely rare neoplasms. A female patient in her 50s was hospitalized due to upper gastrointestinal bleeding after a recent coronary stenting. Gastroscopy with a biopsy established an ulcer-type gastric adenocarcinoma. Contrast-enhanced computer tomography (CT) detected additionally an enlarged spleen with a hypodense, well-marked tumor inside. Neither CT, ultrasound, nor PET-CT imaging were conclusive about its type. Gastrectomy, omentectomy, splenectomy and lymphonodal dissection were performed. Histological and immunohistochemical studies proved a gastric adenocarcinoma and a synchronous splenic inflammatory myofibroblastic tumor resected in negative margins. After receiving chemotherapy, the patient is without any data for recurrence. The splenic inflammatory myofibroblastic tumor remains a diagnostic challenge due to the lack of specific clinical and imaging signs, especially in a case with a synchronous abdominal tumor. So, histopathological examination with immunohistochemistry performed by an experienced pathologist is crucial. This paper presents a unique coincidence of epithelial malignant and mesenchymal tumor–gastric cancer and splenic inflammatory myofibroblastic tumor. Hopefully, this report will be valuable in future investigations about these neoplasms’ genesis, diagnosis, and treatment.

Keywords

• gastric cancer
• splenic myofibroblastic tumor
• inflammatory pseudotumor
• surgical resection
• immunohistochemistry