Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 14, 2006; 12(18): 2958-2961
Published online May 14, 2006. doi: 10.3748/wjg.v12.i18.2958
Gastric signet-ring adenocarcinoma presenting with breast metastasis
Anastasios L Boutis, Charalambos Andreadis, Frideriki Patakiouta, Despina Mouratidou
Anastasios L Boutis, Charalambos Andreadis, Despina Mouratidou, 3rd Department of Clinical Oncology, Theagenion Cancer Hospital, Thessaloniki, Greece
Frideriki Patakiouta, Division of Pathology, Theagenion Cancer Hospital, Thessaloniki, Greece
Correspondence to: Dr. Anastasios Boutis, 3rd Department of Clinical Oncology, Theagenion Cancer Hospital, 54007, Thessaloniki, Greece. tboutis@otenet.gr
Telephone: +30-231-898720 Fax: +30-231-256909
Received: November 17, 2005
Revised: November 28, 2005
Accepted: January 18, 2006
Published online: May 14, 2006
Abstract

Breast metastases from gastric cancer are extremely rare. A case report of a 37-year-old female with breast inflammatory invasion and ascites is described. Breast biopsy revealed carcinomatous invasion of the lymphatics from adenocarcinoma cells with signet-ring features. Estrogen (ER) and progesterone receptors (PR) and c-erb-B2 were negative. Upper gastrointestinal endoscopy revealed a prepyloric ulcerative mass. Histopathologic examination of the lesion showed infiltration from a high-grade adenocarcinoma, identical with that of the breast. Immunostaining was positive for cytokeratins CK-7 and CK-20 and CEA and negative for ER and PR. Ascitic fluid cytology was positive for adenocarcinoma cells. Mammography was not diagnostic. Abdominal CT scanning revealed large ovarian masses suggestive of metastases (Krukenberg’s tumor). A cisplatin-based regimen was given but no objective response was observed. The patient died six months after initial diagnosis. A review of the literature is performed.

Keywords: Gastric adenocarcinoma, Signet-ring, Breast metastasis, Ovarian metastasis