Adenoacanthoma of the stomach is a rare lesion of obscure origin. Approximately 43
anthenticated cases of primary adenoacanthoma of the stomach have been compiled since
the first description made by Rolleston and Trevor in 1905. No special clinical features
could be found which help to separate this unusual cell type from the usual
adenocarcinoma.
Three theories concerning the origin of these unusual tumors are 1) squamous cell
metaplasia. 2)heterotopic islands of squamous cells, and 3) tumor cells arising from the
direct stimulation of undifferentiated multipotential cells in gastric mucosa.
A 37-year-old Korean male was admitted to Seoul National university Hospital
because of rapid weight loss, vomiting and epigastric fullness of 3 months duration.
Physical examination revealed a 47kg. weighing male, but showing essentially negative
in that no abdominal masses were palpable, no lymphadenopathy was noted, and rectal
examination was normal. The significant laboratory data included an upper
gastrointestinal series which demonstrated an large filling defect in pyloric antrum along
the greater curvature, and findings of pyloric stenosis.
The resected stomach contained a polypoid, focally ulcerating neoplastic mass
measuring 4 cm. in max-imum cross, which is infiltrating deep into muscularis. Serosa
is partly involved grossly by neoplastic tissue, and several swollen lymph nudes were
encountered along the greater curvature. Microscopic examination revealed infiltrating
tumor masseses that are comprised partly by differentiated, focally pearl forming
squamous cell nests invading into external muscularis. In areas there are atypical
glandular component, with evidence of mucin production.
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