Background: The synchronous occurrence of gastric adenocarcinoma and gastrointestinal stromal tumors is extremely rare. We report a case of synchronous gastric adenocarcinoma and three stromal tumors, incidentally detected in the stomach and in the esophagus. Case Report:A 67-year-old woman presented with nausea, vomiting,and abdominal pain. Ultrasound and CT scans revealed a thickening of the wall of the stomach and cholelithiasis. Upper gastrointestinal endoscopy demonstrated a mass in the distal stomach. Histological examination of the endoscopic biopsy specimens showed a poorly differentiated adenocarcinoma. The patient underwent total gastrectomy and cholecystectomy. Microscopically,the gastric tumor was a poorly differentiated adenocarcinoma. Microscopic examination also showed one stromal nodule in the stomach and two nodules in the esophagus at the proximal resection margin which were composed of spindle cells with no pleomorphism and mitotic activitiy. Immunohistochemically, all three nodules were focally positive for CD117 and negative for CD34, smooth muscle actin, S-100 protein, desmin, and Ki-67. Conclusion: Synchronous gastric tumors may be detected preoperatively by endoscopic ultrasound. Moreover,the extratumoral wall of the stomach should be meticulously palpated during surgery to rule out any synchronous tumors.

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2007
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