A tumoral lesion that includes four distinct components: a gastric composite tumor with liver metastasis.

A composite carcinoma is a special tumor in which at least two different malignant cell types are blended. Such tumors have been documented in numerous gastrointestinal organs, but rarely occur in the stomach. Usually, they consist of an adenocarcinoma and neuroendocrine components (1-3). Here, we present a 64-year-old man with a gastric composite tumor including adenocarcinoma, neuroendocrine-, squamous cell-, and clear cell-carcinoma components. To our knowledge, no similar case has been reported in the English language literature to date. In addition to its exceptionality, this case demonstrates the metastases of three distinct components to the liver, which has not been reported previously.