Long-term remission of microsatellite instability-high adenosquamous carcinoma in gastric antrum: a case report
BackgroundGastric adenosquamous carcinoma (ASC) is an exceedingly rare neoplasm. Its infrequent occurrence has resulted in sparse literature on its diagnosis and management, presenting considerable challenges for clinical practice.Case presentationA 70-year-old male presented with epigastric pain an...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1516966/full |
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| author | Peng Zhang Jing Yang Yongyong Liu Qing Zhou Caiqiang Xue Bin Zhang Yumin Li |
| author_facet | Peng Zhang Jing Yang Yongyong Liu Qing Zhou Caiqiang Xue Bin Zhang Yumin Li |
| author_sort | Peng Zhang |
| collection | DOAJ |
| description | BackgroundGastric adenosquamous carcinoma (ASC) is an exceedingly rare neoplasm. Its infrequent occurrence has resulted in sparse literature on its diagnosis and management, presenting considerable challenges for clinical practice.Case presentationA 70-year-old male presented with epigastric pain and, upon gastroscopy and CT imaging, was found to have a mass in the gastric antrum. Histopathological analysis confirmed the diagnosis of adenosquamous carcinoma. Immunohistochemical staining revealed a loss of PMS2 and MLH-1 expression, while molecular analysis confirmed MLH-1 methylation, suggesting a microsatellite instability-high (MSI-H) phenotype. The PD-L1 combined positive score (CPS) was remarkably elevated at 80. Postoperatively, the patient received six cycles of oxaliplatin in conjunction with PD-1 inhibitor therapy. At the one-year follow-up, the patient remained in long-term remission, with no evidence of recurrence.ConclusionThis case underscores the potential efficacy of integrating surgery, chemotherapy, and immunotherapy in managing gastric ASC, particularly in the context of MSI-H and elevated PD-L1 expression. It further emphasizes the critical role of comprehensive molecular profiling in guiding personalized therapeutic strategies for such rare malignancies. Further research and additional case reports are imperative to establish optimal management protocols for gastric ASC and to enhance long-term outcomes. |
| format | Article |
| id | doaj-art-d2cf0392ef7849c895e7f26125d711fa |
| institution | OA Journals |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-d2cf0392ef7849c895e7f26125d711fa2025-08-20T02:16:39ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-04-011510.3389/fonc.2025.15169661516966Long-term remission of microsatellite instability-high adenosquamous carcinoma in gastric antrum: a case reportPeng Zhang0Jing Yang1Yongyong Liu2Qing Zhou3Caiqiang Xue4Bin Zhang5Yumin Li6Department of Pathology, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaDepartment of Pathology, Chengdu Integrated Traditional Chinese Medicine (TCM) and Western Medicine Hospital, Chengdu, Sichuan, ChinaDepartment of General Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaDepartment of Radiology, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaDepartment of Radiology, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaDepartment of Radiology, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaGansu Province Key Laboratory of Environmental Oncology, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaBackgroundGastric adenosquamous carcinoma (ASC) is an exceedingly rare neoplasm. Its infrequent occurrence has resulted in sparse literature on its diagnosis and management, presenting considerable challenges for clinical practice.Case presentationA 70-year-old male presented with epigastric pain and, upon gastroscopy and CT imaging, was found to have a mass in the gastric antrum. Histopathological analysis confirmed the diagnosis of adenosquamous carcinoma. Immunohistochemical staining revealed a loss of PMS2 and MLH-1 expression, while molecular analysis confirmed MLH-1 methylation, suggesting a microsatellite instability-high (MSI-H) phenotype. The PD-L1 combined positive score (CPS) was remarkably elevated at 80. Postoperatively, the patient received six cycles of oxaliplatin in conjunction with PD-1 inhibitor therapy. At the one-year follow-up, the patient remained in long-term remission, with no evidence of recurrence.ConclusionThis case underscores the potential efficacy of integrating surgery, chemotherapy, and immunotherapy in managing gastric ASC, particularly in the context of MSI-H and elevated PD-L1 expression. It further emphasizes the critical role of comprehensive molecular profiling in guiding personalized therapeutic strategies for such rare malignancies. Further research and additional case reports are imperative to establish optimal management protocols for gastric ASC and to enhance long-term outcomes.https://www.frontiersin.org/articles/10.3389/fonc.2025.1516966/fulllong-term remissionmicrosatellite instability-highadenosquamous carcinomagastric antrumcase report |
| spellingShingle | Peng Zhang Jing Yang Yongyong Liu Qing Zhou Caiqiang Xue Bin Zhang Yumin Li Long-term remission of microsatellite instability-high adenosquamous carcinoma in gastric antrum: a case report Frontiers in Oncology long-term remission microsatellite instability-high adenosquamous carcinoma gastric antrum case report |
| title | Long-term remission of microsatellite instability-high adenosquamous carcinoma in gastric antrum: a case report |
| title_full | Long-term remission of microsatellite instability-high adenosquamous carcinoma in gastric antrum: a case report |
| title_fullStr | Long-term remission of microsatellite instability-high adenosquamous carcinoma in gastric antrum: a case report |
| title_full_unstemmed | Long-term remission of microsatellite instability-high adenosquamous carcinoma in gastric antrum: a case report |
| title_short | Long-term remission of microsatellite instability-high adenosquamous carcinoma in gastric antrum: a case report |
| title_sort | long term remission of microsatellite instability high adenosquamous carcinoma in gastric antrum a case report |
| topic | long-term remission microsatellite instability-high adenosquamous carcinoma gastric antrum case report |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1516966/full |
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