{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T09:40:26Z","timestamp":1777887626161,"version":"3.51.4"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and highly aggressive hematologic malignancy that commonly presents with skin involvement and may also involve the bone marrow, peripheral blood, and lymph nodes. The coexistence of BPDCN with a primary solid tumor is extremely uncommon and poses substantial diagnostic and therapeutic challenges. We report a 70-year-old man who was first diagnosed with BPDCN after excision of a left forearm lesion and later developed recurrent hematemesis during chemotherapy. Subsequent endoscopic evaluation revealed a bleeding cardia lesion, and repeat biopsy confirmed poorly differentiated gastric cardia adenocarcinoma. After multidisciplinary evaluation, radical gastrectomy was performed first to control tumor-related bleeding, after which systemic chemotherapy for BPDCN was resumed. This case suggests that, in BPDCN patients who develop hematemesis, progressive anemia, or weight loss during treatment, prompt evaluation for a second primary gastrointestinal malignancy is warranted, and control of active tumor-related bleeding may need to precede hematologic therapy.<\/jats:p>","DOI":"10.3389\/fonc.2026.1841250","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:19:10Z","timestamp":1777609150000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Tumor-related hemorrhage determined treatment sequencing in blastic plasmacytoid dendritic cell neoplasm coexisting with gastric cardia adenocarcinoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuze","family":"Li","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, The Affiliated Huai\u2019an No. 1 People\u2019s Hospital of Nanjing Medical University","place":["Huai\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenggong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, The Affiliated Huai\u2019an No. 1 People\u2019s Hospital of Nanjing Medical University","place":["Huai\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xudong","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, The Affiliated Huai\u2019an No. 1 People\u2019s Hospital of Nanjing Medical University","place":["Huai\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoquan","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, The Affiliated Huai\u2019an No. 1 People\u2019s Hospital of Nanjing Medical University","place":["Huai\u2019an, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2013-0101-R","article-title":"Blastic plasmacytoid dendritic cell neoplasm: a clinicopathologic review","volume":"138","author":"Shi","year":"2014","journal-title":"Arch Pathol Lab Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-10-3297","article-title":"TCL1 expression in plasmacytoid dendritic cells (DC2s) and the related CD4+ CD56+ blastic tumors of skin","volume":"101","author":"Herling","year":"2003","journal-title":"Blood"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000156","article-title":"Blastic plasmacytoid dendritic cell neoplasms: clinico-immunohistochemical correlations in a series of 91 patients","volume":"38","author":"Julia","year":"2014","journal-title":"Am J Surg 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