27 September 2025
: Case report 
SMARCA4-Deficient Undifferentiated Carcinoma: A Report of 2 Cases
Rare disease
Sa-Hong Kim ABDEF 1,2, Kyoyoung Park D 1,2, Jane Chungyoon Kim D 1,2, Jeesun Kim D 1,2, Do-Joong Park D 1,2,3, Hyuk-Joon Lee D 1,2,3, Han-Kwang Yang D 1,2,3, Yoonjin Kwak ABDEF 4,5, Seong-Ho Kong ABDEF 1,2,3*DOI: 10.12659/AJCR.949989
Am J Case Rep 2025; 26:e949989
Table 1 Comparison of clinical and pathological features of the two cases.
| Category | Case 1 | Case 2 |
|---|---|---|
| Age/sex | 71/Female | 80/Male |
| Medical history | Hypertension, dyslipidemia | Hypertension, type 2 diabetes, CKD, BPH, smoking |
| Presenting symptoms | Nausea, dyspepsia, weight loss | Fatigue, weight loss |
| Location | Gastric cardia | Gastric cardia |
| Tumor size in CT | 13.6×13.0×9.0 cm | 9.0×7.4×4.6 cm |
| Invasion in CT | Pancreas, colon | Pancreas tail |
| Metastasis in CT | None | None |
| Surgery | Open total gastrectomy with distal pancreatectomy and segmental colectomy | Laparoscopic total gastrectomy with distal pancreatectomy |
| Pathology | pT4bN0(0/12) M0SMARCA4-deficient undifferentiated tumor | pT4bN2(4/62) M0SMARCA4-deficient undifferentiated tumor with poorly differentiated tubular adenocarcinoma component (20%) |
| Immunohistochemistry (IHC) | Loss of BRG1High Ki-67 (80%) | Loss of BRG1High Ki-67 |
| Metastasis after surgery | Yes;Multiple liver metastases | No |
| Chemo | Paclitaxel + Carboplatin (1 cycle) | XELOX (5 cycles) |
| Outcome | Transferred for hospice care | Surveillance without recurrence |
| CKD – chronic kidney disease; BPH – benign prostatic hyperplasia; CT – computed tomography; IHC – immunohistochemistry; XELOX – combination Xeloda (capecitabine, an oral prodrug of 5-fluorouracil) and oxaliplatin. | ||