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Case Study
- Gastric amphicrine carcinoma in the stomach: an unexpected presentation of MUTYH-associated polyposis
- Seungkyun Lee, Byung-Hoon Min, Young-Gon Kim, Soomin Ahn, Kyoung-Mee Kim
- Received April 17, 2026 Accepted June 24, 2026 Published online September 7, 2026
- DOI: https://doi.org/10.4132/jptm.2026.06.24 [Epub ahead of print]
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Abstract
PDF - Amphicrine carcinomas of the stomach, defined by dual exocrine and neuroendocrine differentiation within the same neoplastic cell, are exceedingly rare. MUTYH-associated polyposis (MAP) is an autosomal recessive polyposis syndrome characterized by multiple colorectal adenomas and variable upper gastrointestinal involvement; however, amphicrine carcinomas have not been previously documented in this setting. We report a gastric amphicrine carcinoma arising in the background of extensive fundic gland polyposis in a patient with MAP. Endoscopy revealed a 3.5-cm flat elevated lesion in the gastric fundus amid extensive fundic gland polyposis. Histologically, the tumor consisted of a single population of cells exhibiting combined glandular and neuroendocrine differentiation without zonal or biphasic architecture, and many of these cells demonstrated true amphicrine morphology. Immunohistochemistry confirmed co-expression of cytokeratin and the neuroendocrine markers chromogranin A and synaptophysin in the same cell population. Germline targeted next-generation sequencing identified biallelic MUTYH variants in trans (c.733C>T, p.Arg245Cys [likely pathogenic]; c.842C>T, p.Ala281Val [variant of uncertain significance]), supporting a diagnosis of MAP. To our knowledge, this is the first reported case of a gastric amphicrine carcinoma in a MAP patient, expanding the spectrum of MAP-associated upper gastrointestinal neoplasia and underscoring the importance of vigilant endoscopic surveillance in hereditary polyposis syndromes.
Case Report
- Ultrasound-guided cryoablation of recurrent thyroid cancer: radiologic-pathologic correlation
- Yeseul Kim, Jae Ho Shin, Kyeong Jin Kim, Soo Myoung Shin, Dawon Park
- Received February 11, 2026 Accepted June 4, 2026 Published online August 3, 2026
- DOI: https://doi.org/10.4132/jptm.2026.06.04 [Epub ahead of print]
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Abstract
PDF
Supplementary Material - Cryoablation is a minimally invasive thermal ablation modality that destroys tumor cells through intracellular ice crystal formation and osmotic injury. Although it offers theoretical advantages, its application in recurrent papillary thyroid cancer (PTC) remains limited, and the radiologic-pathologic findings of treatment response have not been well characterized. A 55-year-old male patient with biopsy-proven recurrent PTC in the left supraclavicular fossa and a history of total thyroidectomy, neck dissection, and advanced colorectal cancer underwent a single-session ultrasound-guided cryoablation. The 20-minute procedure was completed without complications. Immediately post-ablation, the lesion volume increased by over 200% with marked hypoechogenicity and obliteration of abnormal feeding vessels on microvascular imaging. Pathology demonstrated disrupted tumor cell membranes, necrotic changes, and myxoid peritumoral stromal alteration, consistent with direct and indirect injuries caused by cryoablation. At the first-month follow-up, repeat biopsy showed no viable tumor, with subacute inflammatory infiltrates, histiocytic aggregates, and progressive fibrosis. On ultrasound, a volume reduction rate of 71.4% was achieved at one month follow-up and 97.1% at three months follow-up. This case report provides the first radiologic-pathologic findings of both immediate and delayed effects of cryoablation in recurrent PTC, supporting its role as a promising minimally invasive palliative therapy.
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