Aggressive undifferentiated pleomorphic sarcoma of the stomach involving long-term survival: A case report and literature review

Oguri,Yohei; Cho,Haruhiko; Oohinata,Ryouki; Onoyama,Haruna; Takada,Ryosuke; Motoi,Toru

doi:10.3892/mco.2018.1739

Aggressive undifferentiated pleomorphic sarcoma of the stomach involving long-term survival: A case report and literature review

Authors:
- Yohei Oguri
- Haruhiko Cho
- Ryouki Oohinata
- Haruna Onoyama
- Ryosuke Takada
- Toru Motoi
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Affiliations: Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113‑0021, Japan, Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113‑0021, Japan
Published online on: October 5, 2018 https://doi.org/10.3892/mco.2018.1739
Pages: 661-665

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Abstract

Primary gastric undifferentiated pleomorphic sarcoma (UPS) is a rare disease with insufficient long‑term follow‑up data. In the present study, a 70‑year‑old male complained of abdominal fullness and visited our hospital. Abdominal computed tomography revealed a large tumor in the upper part of the stomach, which was accompanied by smaller tumors in the small intestinal mesentery. An endoscopic ultrasound‑guided fine‑needle biopsy examination of the gastric tumor revealed features of pleomorphic sarcoma and high‑grade spindle‑shaped cells. Total gastrectomy was performed on the primary tumor, together with combined resection of the small intestine for the metastatic tumors. However, the tumor recurred in the mesentery of the sigmoid colon 6 months after the operation. A second operation was performed to resect the recurrent tumor. Since the second surgical procedure, the patient has remained free from recurrence for >7 years. Although the prognosis of abdominal UPS was considered to be poor, even after curative surgery, the present case experienced a long‑term survival of gastric UPS after undergoing surgical resection alone.

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1	Fletcher CDM, Bridge JA, Hogendoorn P and Mertens F: WHO classification of tumours of soft tissue and bone. (4th). IARC Press. (Lyon). pp120–122. 2013.
2	O'Brien JE and Stout AP: Malignant fibrous xanthomas. Cancer. 17:1445–1455. 1964. View Article : Google Scholar : PubMed/NCBI
3	Sano T and Aiko T: New Japanese classifications and treatment guidelines for gastric cancer: Revision concepts and major revised points. Gastric Cancer. 14:97–100. 2011. View Article : Google Scholar : PubMed/NCBI
4	Soufi M, Errougani A and Chekkof RM: Primary gastric leiomyosarcoma in young revealed by a massive hematemesis. J Gastrointest Cancer. 40:69–72. 2009. View Article : Google Scholar : PubMed/NCBI
5	Kabashima A, Kimura K, Sanefuji K, Masunari S, Haraoka S and Maekawa S: A case of primary gastric undifferentiated high-grade pleomorphic sarcoma diagnosed with chief complaint of fever: A case report and literature review. Surg Case Rep. 3:412017. View Article : Google Scholar : PubMed/NCBI
6	Welch JP: Smooth muscle tumors of the stomach. Am J Surg. 130:279–285. 1975. View Article : Google Scholar : PubMed/NCBI
7	Farid M, Demicco EG, Garcia R, Ahn L, Merola PR, Cioffi A and Maki RG: Malignant peripheral nerve sheath tumors. Oncologist. 19:193–201. 2014. View Article : Google Scholar : PubMed/NCBI
8	Virgilio E, Mercantini P, Tarantino G, Socciarelli F, Pilozzi E, Uccini S, Caterino S and Ziparo V: Gastrointestinal stromal tumors with de novo anaplastic dedifferentiation: Considerations on a little-known neoplastic metamorphosis. Int J Surg Pathol. 22:3852014. View Article : Google Scholar : PubMed/NCBI
9	McGovern Y, Zhou CD and Jones RL: Systemic therapy in metastatic or unresectable well-differentiated/dedifferentiated liposarcoma. Front Oncol. 7:2922017. View Article : Google Scholar : PubMed/NCBI
10	Villanueva A, Pérez C, Sabaté JM, Llauger J and Monill JM: CT manifestations of peritoneal leiomyosarcomatosis. Eur J Radiol. 17:166–169. 1993. View Article : Google Scholar : PubMed/NCBI
11	Giganti F, Orsenigo E, Esposito A, Chiari D, Salerno A, Ambrosi A, Albarello L, Mazza E, Staudacher C, Del Maschio A, et al: Prognostic role of diffusion weighted MR imaging for resectable. Gastric cancer. Radiology. 276:444–452. 2015. View Article : Google Scholar : PubMed/NCBI
12	Italiano A, Delva F, Mathoulin-Pelissier S, Le Cesne A, Bonvalot S, Terrier P, Trassard M, Michels JJ, Blay JY, Coindre JM and Bui B: Effect of adjuvant chemotherapy on survival in FNCLCC grade 3 soft tissue sarcomas: A multivariate analysis of the French Sarcoma Group database. Ann Oncol. 21:2436–2441. 2010. View Article : Google Scholar : PubMed/NCBI
13	Agaimy A, Gaumann A, Schroeder J, Dietmaier W, Hartmann A, Hofstaedter F, Wünsch PH and Mentzel T: Primary and metastatic high-grade pleomorphic sarcoma/malignant fibrous histiocytoma of the gastrointestinal tract: An approach to the differential diagnosis in a series of five cases with emphasis on myofibroblastic differentiation. Virchows Arch. 451:949–957. 2007. View Article : Google Scholar : PubMed/NCBI
14	Wada Y, Matsushita T, Sarumaru S, Ryo J, Isobe H, Satoh B, Kanaya S, Katayama T and Ohtoshi M: Malignant fibrous histiocytoma of the stomach: Report of two cases. Surg Today. 28:296–300. 1998. View Article : Google Scholar : PubMed/NCBI
15	Rathakrishnan V, Arianayagam S and Kumar G: Primary malignant fibrous histiocytoma of the stomach: (A case report). Australas Radiol. 33:302–304. 1989. View Article : Google Scholar : PubMed/NCBI
16	Wright JR Jr, Kyriakos M and DeSchryver-Kecsemeti K: Malignant fibrous histiocytoma of the stomach. A report and review of malignant fibrohistiocytic tumors of the alimentary tract. Arch Pathol Lab Med. 112:251–258. 1988.PubMed/NCBI
17	Shibuya H, Azumi N, Onda Y and Abe F: Multiple primary malignant fibrous histiocytoma of the stomach and small intestine. Acta Pathol Jpn. 35:157–164. 1985.PubMed/NCBI
18	Morita T, Kato T, Furukawa K and Itoh Y: A case report of malignant fibrous histiocytoma in the regions of stomach and gall bladder. J Jpn Soc Clin Cytol. 23:425–429. 1984. View Article : Google Scholar
19	Pasquali S and Gronchi A: Neoadjuvant chemotherapy in soft tissue sarcomas: Latest evidence and clinical implications. Ther Adv Med Oncol. 9:415–429. 2017. View Article : Google Scholar : PubMed/NCBI
20	Guo J, Cui Q, Liu C, Sui J, Jiang N, Zhou J, Li D and Zeng Y: Clinical report on transarterial neoadjuvant chemotherapy of malignant fibrous histiocytoma in soft tissue. Clin Transl Oncol. 15:370–375. 2013. View Article : Google Scholar : PubMed/NCBI
21	NCCN Guidelines for Patients. Soft Tissue Sarcoma. Version 1. 2014, https://www.nccn.org/patients/guidelines/sarcomaApril 12–2018