Gastric carcinoma with osteoclast-like giant cells

Extraskeletal neoplasms with osteoclast-like giant cells are uncommon. Thes e tumors are most frequently reported in the breast and pancreas, and are r elatively rare in other sites. We report a case of primary gastric adenocar cinoma with an infiltrate of osteoclast-like giant cells. The patient is a 64-yr-old black woman who presented with epigastric pain and was found to h ave a mass in the gastric antrum. Histological examination showed a poorly differentiated adenocarcinoma with an infiltrate of osteoclast-like giant c ells. The giant cells were present both in the primary gastric adenocarcino ma and in the lymph node metastases. Immunohistochemical stains demonstrate d that the giant cells were of monocytic/histiocytic origin and probably re present a distinctive host response to the tumor. The patient is alive and well 12 months after resection. This is the second published report of gast ric carcinoma with osteoclast-like giant cells. Based on this Limited exper ience, gastric carcinoma with osteoclast-like giant cells may represent a d istinct clinicopathological entity with a more favorable prognosis. (Am J G astroenterol 1999;94:1678 -1681. (C) 1999 by Am. Cell. of Gastroenterology) .