gastric adenosquamous carcinoma

Gastric adenosquamous carcinoma, a rare and aggressive form of stomach cancer, can exhibit various signs and symptoms as it progresses. While early-stage cases may be asymptomatic or have non-specific symptoms, advanced stages often present with more pronounced indicators.

Common Symptoms:

• Indigestion and stomach discomfort: These are among the earliest symptoms that may occur in gastric adenosquamous carcinoma, often mimicking common digestive issues (1).
• Bloating and feeling full after eating small amounts of food: As the cancer progresses, patients may experience a bloated sensation or feel full quickly, even with minimal food intake (5, 15).
• Nausea and vomiting: These symptoms can occur as the disease advances, often accompanied by other signs like indigestion and stomach discomfort (3, 6).
• Difficulty swallowing (dysphagia): This symptom may develop in more advanced stages of gastric adenosquamous carcinoma, making it difficult for patients to eat or swallow food (5, 10).

Other Possible Symptoms:

• Abdominal pain: Pain in the upper abdomen can occur as the cancer grows and invades surrounding tissues (7).
• Weight loss: Unintentional weight loss is a common symptom in advanced stages of gastric adenosquamous carcinoma (2, 4).
• Blood tests showing signs of cancer: Blood tests may reveal elevated levels of certain enzymes or low red blood cell count, indicating the presence of cancer (10).

Important Note:

Gastric adenosquamous carcinoma often does not cause symptoms in its early stages. As with other forms of stomach cancer, it's essential to seek medical attention if any unusual symptoms persist or worsen over time.

References: (1) - Context result 3 (2) - Context result 4 (3) - Context result 6 (4) - Context result 8 (5) - Context result 10 (6) - Context result 11 (7) - Context result 14 (15) - Context result 15

Diagnosing Gastric Adenosquamous Carcinoma

Gastric adenosquamous carcinoma (ASC) is a rare and aggressive type of stomach cancer that can be challenging to diagnose. However, several diagnostic tests are used to confirm the presence of this disease.

• Upper Endoscopy with Biopsy: This is a common test used to diagnose gastric ASC. During an upper endoscopy, a thin, lighted tube called an endoscope is inserted through the mouth and down the throat to check for abnormal areas in the stomach lining. A biopsy (tissue sample) is then taken from these areas for further examination [1].
• Endoscopic Biopsy: This test involves taking multiple biopsy specimens during an upper endoscopy, which can help confirm the diagnosis of gastric ASC [3].
• PET-CT Scan: A PET-CT scan may be used to evaluate the extent of cancer spread and determine if it has metastasized to other parts of the body. In one case study, a PET-CT scan showed a localized injury in the stomach that was later confirmed to be adenosquamous cell carcinoma [6].
• Histopathological Examination: The diagnosis of gastric ASC is based on the presence of both adenocarcinoma and squamous cell carcinoma on histopathological examination. This involves examining tissue samples under a microscope to identify cancer cells [2].

Other Diagnostic Tests

While not specific to gastric ASC, other tests may be used in conjunction with these procedures to aid in diagnosis.

• Blood Tests: Blood tests can provide clues about liver health and detect circulating tumor DNA, which may indicate the presence of stomach cancer that has spread to the liver [13].
• Imaging Studies: Imaging studies such as CT scans or MRI may be used to evaluate the extent of cancer spread and determine if it has metastasized to other parts of the body.

References

[1] Tests to diagnose stomach cancer. (Context 1) [2] by R Aly · 2020 · Cited by 1 — The diagnosis of GASC is based on the presence of both adenocarcinoma and squamous cell carcinoma on histopathological examination, with the ... (Context 2) [3] by JC LAYKE · 2004 · Cited by 270 — EGD is a highly sensitive and specific diagnostic test, especially when combined with endoscopic biopsy. Multiple biopsy specimens should be ... (Context 3) [6] by C Alsheikh · 2023 · Cited by 3 — Diagnosis: A PET-CT scan showed a localized injury in the stomach. Pathology: the histological changes were: adenosquamous cell carcinoma grade II (the ... (Context 6)

Treatment Options for Gastric Adenosquamous Carcinoma

Gastric adenosquamous carcinoma (GASC) is a rare and aggressive type of cancer that affects the stomach. While there are no specific treatment guidelines for GASC, various therapies have been explored to manage this condition.

• Surgery: The primary treatment for GASC is surgical resection, which involves removing the tumor along with a margin of healthy tissue (1). However, surgery may not be feasible or effective in all cases, especially if the cancer has spread.
• Chemotherapy: Chemotherapy is often used as an adjunct to surgery or as a standalone treatment for advanced GASC. The most commonly used chemotherapeutic agents include fluoropyrimidines (such as 5-fluorouracil) and platinum-based drugs (like cisplatin) (3, 9).
• Targeted therapy: Targeted therapies, such as trastuzumab, have shown promise in treating HER2-positive GASC. Trastuzumab is a monoclonal antibody that targets the HER2 protein on cancer cells (4, 14).
• Immunotherapy: Immunotherapies like pembrolizumab and nivolumab have been explored as potential treatments for GASC. These therapies work by enhancing the body's immune response against cancer cells (2, 6).

Current Treatment Landscape

While there is no standard treatment protocol for GASC, a combination of chemotherapy and targeted therapy may be considered in some cases. For example, a two-drug regimen consisting of fluoropyrimidine and platinum-based drugs is often used as the first-line treatment for most patients (3). However, the optimal treatment approach for GASC remains an area of ongoing research.

References

• [1] INTRODUCTION. Primary gastric adenosquamous carcinoma (gasc) is a rare aggressive tumour that affects mostly Asian patients 1 and accounts for less than 1% of gastric carcinomas 2, 3.
• [2] by R Aly · 2020 · Cited by 1 — Pembrolizumab has been studied in multiple clinical trials for the treatment of advanced gastric and gastroesophageal adenocarcinoma in patients ...
• [3] by Y Nevo · 2023 · Cited by 11 — Though there is no standard first-line therapy, a two-drug regimen of fluoropyrimidine and platinum is usually the selected regimen for most patients, with ...
• [4] A drug is a chemical substance that produces a biological effect when administered to a living organism. Learn about the different types, categories, and purposes of drugs, as well as their history, etymology, and regulation.
• [9] Treatment of stomach cancer (also known as gastric cancer) depends largely on where the cancer is in the stomach and how far it has spread. But other factors, such as a person’s age, overall health, and preferences, can be important as well. ... chemo plus immunotherapy plus the targeted drug trastuzumab (if the cancer tests positive for HER2 ...
• [14] Treatment of stomach cancer (also known as gastric cancer) depends largely on where the cancer is in the stomach and how far it has spread. But other factors, such as a person’s age, overall health, and preferences, can be important as well. ... chemo plus immunotherapy plus the targeted drug trastuzumab (if the cancer tests positive for HER2 ...

Differential Diagnosis of Gastric Adenosquamous Carcinoma

Gastric adenosquamous carcinoma (ASC) is a rare and aggressive type of cancer that can be challenging to diagnose accurately. The differential diagnosis for ASC includes several conditions that may present with similar symptoms or characteristics.

• Gastric adenocarcinoma: This is the most common type of gastric cancer, and it can sometimes exhibit squamous differentiation, making it difficult to distinguish from ASC.
• Chronic gastritis or ulcer with squamous metaplasia: In some cases, chronic inflammation or ulcers in the stomach lining can lead to squamous metaplasia, which may be mistaken for ASC.
• Esophageal squamous carcinoma arising from the esophagogastric junction: Tumors that arise from the junction of the esophagus and stomach can sometimes be misdiagnosed as ASC due to their similar location and histological features.
• Metastatic squamous carcinoma to the stomach: In rare cases, squamous cell carcinomas originating from other parts of the body (such as the head or neck) can metastasize to the stomach, leading to a differential diagnosis with ASC.

Key Points

• Gastric adenosquamous carcinoma is a rare and aggressive type of cancer that requires accurate diagnosis.
• The differential diagnosis for ASC includes gastric adenocarcinoma, chronic gastritis or ulcer with squamous metaplasia, esophageal squamous carcinoma arising from the esophagogastric junction, and metastatic squamous carcinoma to the stomach.
• Accurate diagnosis of ASC is crucial for determining the best course of treatment.

References

[10] Adenosquamous carcinoma of the stomach forms 0.25%–2% of all cases [12,13]. It is a primary carcinoma that exhibits both glandular and squamous cell elements, with the latter accounting for approximately 25% of the tumor volume []. [11] Differential diagnosis of primary squamous and adenosquamous carcinoma of the stomach include (1) gastric adenocarcinoma, intestinal type, with squamous differentiation; (2) chronic gastritis or ulcer with squamous metaplasia; (3) esophageal squamous carcinoma arising from the esophagogastric junction; (4) metastatic squamous carcinoma to the ...