Postsurgical radiation therapy for gastric carcinosarcoma with c-kit expression: A case report

Figure 1 Tumor presentation. A: Gastroscopy revealed a large exophytic and lobular tumor occupying the upper part of the stomach; B: Computed tomography demonstrated a large tumor in the gastric wall and enlarged lymph nodes around the stomach (arrow).

Figure 2 Histopathology. A: Surgical resection revealed a large tumor (75 mm × 75 mm) with central ulceration (Borrmann type III) occupying the anterior wall of the upper body of the stomach; Hematoxylin and eosin staining revealed B: Biphasic structure consisting of tubular adenocarcinoma and spindle cell sarcoma (20 ×); C: Epithelial components showing that the parenchyma structure of the common gastric adenocarcinoma was surrounded with sarcomatous stroma (200 ×); D: Sarcomatous cells proliferating diffusely in a stream pattern (200 ×); E: Two transitional areas of carcinoma and sarcoma components (20 ×).

Figure 3 Immunohistochemistry. Immunoreactivity for A: C-kit (CD117); B: CD34; C: Cytokeratin (AE1/AE3); D: Vimentin; E: Smooth muscle actin; and F: Desmin (200 ×).

Figure 4 Computed tomography findings. A: Nine months after gastrectomy, enlarged heptohilar lymph nodes were detected; B: Heptohilar lymph nodes were decreased in size after 50 Gy radiotherapy; C: Seventeen months after gastrectomy, enlarged mediastinal lymph nodes were detected; D: Mediastinal lymph nodes were decreased in size after 50 Gy radiotherapy.