胃黏液腺癌 黏液池 影像学诊断

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.

… magnetic resonance imaging (MRI) are the most common diagnostic methods used for evaluating gastrointestinal carcinoma, … for detecting SRCC and mucinous adenocarcinoma (MAC) …

… Contrast enhanced venous phase CT images of 163 patients with pathological diagnosis of gastric adenocarcinoma (n = 125), gastric lymphoma (n = 12) and gastrointestinal stromal …

… as well-/moderately differentiated adenocarcinoma or poorly differentiated/mucinous … slightly lower than that of radiomic nomogram based on radiomic signature and clinical information […

… Gastric cancer remains one of the leading causes of cancer-related mortality 3 worldwide, with locally advanced gastric cancer (… Tumor-based radiomics models have also been widely …