Rare coincidence of gastric cancer and large myofibroblastic tumor of the spleen

Abstract

Although its incidence has been decreasing during the last decades, gastric 
cancer remains a common disease and a global health problem. Conversely, inflammatory myofibroblastic tumors, especially the splenic ones, are extremely rare neoplasms. A female patient in her 50s was hospitalized due to upper gastrointestinal bleeding after 
a recent coronary stenting. Gastroscopy with a biopsy established an ulcer-type gastric adenocarcinoma. Contrast-enhanced computer tomography (CT) detected additionally an enlarged spleen with a hypodense, well-marked tumor inside. Neither CT,  ultrasound, nor PET-CT imaging were conclusive about its type. Gastrectomy, omentectomy, splenectomy and lymphonodal dissection were performed. Histological and immunohistochemical studies proved a gastric adenocarcinoma and a synchronous splenic inflammatory myofibroblastic tumor resected in negative margins. After receiving chemotherapy, the patient is without any data for recurrence. The splenic inflammatory myofibroblastic tumor remains a diagnostic challenge due to the lack of specific clinical and imaging signs, especially in a case with a synchronous abdominal tumor. So, histopathological examination with immunohistochemistry performed by an experienced pathologist is crucial. This paper presents a unique coincidence of epithelial malignant and mesenchymal tumor–gastric cancer and splenic inflammatory myofibroblastic tumor. Hopefully, this report will be valuable in future investigations about these neoplasms’ genesis, diagnosis, and treatment.