A 30-year-old man was admitted to the hospital because of left hypochondralgia on a fasting stomach and tarry stool. Gastroscopy revealed a large submucosal tumor-like lesion in the middle body on the grater curvature. Biopsy of the tumor showed squamous cell carcinoma. Extensive survey did not reveal any cancer except the stomach one; hence the diagnosis of primary squamouscell carcinoma of the stomach was made. Total gastrectomy combined with partialresection of the transverse colon, splenectomy and cholecystectomy was performed. Macroscopic findings revealed a large gastric tumor, about 7cm in longitudinal diameter, laying beneath the mucosal layer. Histological examination disclosed that nearly the whole part of the tumor consisted of pure well differentiated squamous cell carcinoma, except a very limited portion of the gastric mucosa, where poorly differentiated adenocarcinoma with signet ring cell was found, which showed a smooth transition to squamous cell carcinoma. According to the General Rules for the Study of Gastric Cancer, 12th ed., proposed by the Japan Gastric Cancer Association, primaryadenosquamous cell carcinoma of the stomach was diagnosed in this case.
There is no sign of recurrence as of 1 year and 3 months after the operation.