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1
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Toussieng T, Larson BK, Burch M, Gangi A, Gong J, Guindi M, Kozak M, Lai K, Hutchings DA, Waters KM. Clinicopathologic findings in a cohort of metastases to the stomach. Hum Pathol 2024; 154:105694. [PMID: 39580093 DOI: 10.1016/j.humpath.2024.105694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 11/11/2024] [Accepted: 11/18/2024] [Indexed: 11/25/2024]
Abstract
AIMS Metastatic tumors to the stomach can mimic primary gastric adenocarcinoma or be subtle and difficult to identify. The current study aimed to characterize the clinicopathology of metastases to the stomach to aid in diagnosis. METHODS AND RESULTS Forty-three metastatic tumors and 30 primary gastric adenocarcinoma cases were reviewed. Metastases originated from numerous primaries with the most common being mammary (n = 17) or melanoma (n = 9). The gastric metastasis represented the initial diagnosis for 9 (21%) cases without previous history of malignancy. The median age at diagnosis was similar (metastatic 66 years; primary 67.5 years; P = 0.42). The most common indication for procedure was abdominal pain (23%; P = 0.95) in metastases and melena (43%; P < 0.01) in primaries. Procedural findings suggestive of metastasis over primary adenocarcinoma were multiple lesions (23% versus 0%; P = 0.01), non-mass forming mucosal changes (30% versus 0%; P < 0.01), submucosal nodularity (14% versus 0%; P = 0.09), and absence of ulceration (9% versus 53%; P < 0.01). Histologic findings less commonly seen in metastasis were mucosal layer involvement (86% versus 100%; P = 0.09), ulceration (40% versus 70%; P = 0.02), surface epithelial involvement/colonization by tumor (12% versus 60%; P < 0.01), intestinal metaplasia (9% versus 53%; P < 0.01), background dysplasia (0% versus 30%; P < 0.01), and Helicobacter pylori infection (0% versus 20%; P < 0.01). Lymphovascular invasion had similar prevalence (metastatic 23%; primary 20%; P = 0.70). CONCLUSIONS Metastasis to the stomach included a variety of primary sites and was not infrequently the initial diagnosis. Patient demographics were similar to primary adenocarcinoma. Multiple lesions, non-mass forming mucosal changes, and/or submucosal nodularity were more common in metastasis. Histologically, the absence of surface epithelial involvement, ulceration, intestinal metaplasia, background dysplasia, or H. pylori infection can raise suspicion for metastasis.
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Affiliation(s)
- Trevor Toussieng
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Brent K Larson
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Miguel Burch
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Alexandra Gangi
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Jun Gong
- Department of Medicine, Division of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Maha Guindi
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Michael Kozak
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Keith Lai
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Danielle A Hutchings
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Kevin M Waters
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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2
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Alomari A, Obri M, Aldroubi B, Khan MZ, Chaudhary A, Althunibat I, Piraka C, Zuchelli T. Hybrid Endoscopic Submucosal Dissection for Isolated Gastric Metastasis of Renal Cell Carcinoma. ACG Case Rep J 2024; 11:e01548. [PMID: 39493953 PMCID: PMC11527420 DOI: 10.14309/crj.0000000000001548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Accepted: 10/03/2024] [Indexed: 11/05/2024] Open
Abstract
Metastasis to the stomach is a rare occurrence, especially from renal cell carcinoma (RCC). We report a case of a 76-year-old man with a history of RCC, in remission for 11 years postnephrectomy, who presented with gastrointestinal symptoms, was found to have a 2 cm gastric mass confirmed as metastatic RCC. Endoscopic submucosal dissection was attempted, but due to the hypervascular nature of the mass, a hybrid endoscopic submucosal dissection was performed, achieving complete resection. Follow-up at 7 months showed no recurrence, highlighting the potential for endoscopic treatment options for isolated gastric metastasis, despite the lack of specific guidelines.
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Affiliation(s)
- Ahmad Alomari
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI
| | - Mark Obri
- Department of Gastroenterology, Henry Ford Hospital, Detroit, MI
| | | | | | - Ammad Chaudhary
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI
| | - Ismail Althunibat
- Department of Internal Medicine, Saint Michael's Medical Center, Newark, NJ
| | - Cyrus Piraka
- Department of Gastroenterology, Henry Ford Hospital, Detroit, MI
| | - Tobias Zuchelli
- Department of Gastroenterology, Henry Ford Hospital, Detroit, MI
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3
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Lin Y, Wu YL, Zou DD, Luo XL, Zhang SY. Combined gastroscopic and laparoscopic resection of gastric metastatic adenosquamous carcinoma from lung: A case report. World J Gastrointest Surg 2024; 16:3065-3073. [PMID: 39351550 PMCID: PMC11438818 DOI: 10.4240/wjgs.v16.i9.3065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/14/2024] [Accepted: 08/22/2024] [Indexed: 09/18/2024] Open
Abstract
BACKGROUND Primary lung cancer is the leading cause of cancer-related death worldwide. Common metastatic sites include the brain, liver, bones, and adrenal glands. However, gastric metastases from lung cancer are rare. This case may be the first report of a combined gastroscopic and laparoscopic resection for gastric metastatic adenosquamous carcinoma (ASC). CASE SUMMARY We report a case of gastric metastasis from lung cancer. The patient was a 61-year-old Han Chinese female who first attended our hospital complaining of a persistent cough, leading to the diagnosis of advanced-stage lung adenocarcinoma. After more than four years of chemotherapy, the patient began to experience epigastric pain. Endoscopy was performed, and pathological examination of biopsy specimens confirmed that the gastric lesion was a metastasis from lung cancer. The lesion was successfully resected by combined gastroscopy and laparoscopy. Histopathological examination of the resected gastric specimen revealed ASC. CONCLUSION Gastric metastases from lung cancer are rare. Endoscopy, histological and immunohistochemical staining are useful for diagnosing metastatic lesions. Surgical management may provide extended survival in appropriately selected patients.
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Affiliation(s)
- Yin Lin
- Department of Gastroenterology, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
| | - Yi-Long Wu
- Department of Gastroenterology, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
| | - Dong-Dong Zou
- Department of Proctology, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
| | - Xiao-Long Luo
- Department of Gastroenterology, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
| | - Shi-Yan Zhang
- Department of Clinical Laboratory, Fuding Hospital, Fujian University of Traditional Chinese Medicine, Fuding 355200, Fujian Province, China
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Kővári B, Carneiro F, Lauwers GY. Epithelial tumours of the stomach. MORSON AND DAWSON'S GASTROINTESTINAL PATHOLOGY 2024:227-286. [DOI: 10.1002/9781119423195.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Sikora TM, Sinukumar S, Naik S, Jumle N. Rare Case of Metachronous Gastric Metastasis from Primary Ovarian Carcinoma. Indian J Surg Oncol 2024; 15:584-589. [PMID: 39239436 PMCID: PMC11372001 DOI: 10.1007/s13193-024-01947-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/01/2024] [Indexed: 09/07/2024] Open
Abstract
Metastasis of ovarian cancer to the stomach is extremely rare. The tumors most commonly metastasizing to the stomach include melanoma, breast, lung, and oesophageal carcinoma, while ovarian cancer comprises only 0.013-1.6% of all gastric metastatic tumors. The aim of this study was to present a rare case of an isolated metachronous gastric metastasis from an ovarian carcinoma, in a 59-year-old lady. A 59-year-old lady presented with a right adnexal mass on MRI imaging of the abdomen and pelvis and an elevated serum CA 125 of 4240 IU/ml. She underwent a primary cytoreductive surgery comprising of omentectomy, peritoneal biopsies, pelvic peritonectomy and peritoneal washing cytology, hysterectomy and bilateral salpingo-oophorectomy, and a retroperitoneal and pelvic nodal dissection. The surgical Peritoneal Carcinomatosis Index (PCI) was 5. The final histopathology showed a high-grade serous adenocarcinoma involving the right adnexa. She received six cycles of adjuvant chemotherapy. On a 3-monthly follow-up, the PET scan revealed that a gastric fundic lesion was noted. Investigations revealed a metachronous metastasis from the serous carcinoma of the ovary, confirmed by histopathological evaluation. The patient was treated with surgical resection of the metastasis and systemic chemotherapy to achieve disease control. Gastric metastasis from ovarian cancer should be considered a differential diagnosis in any patient presenting with a gastric mass and a history of ovarian cancer.
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Affiliation(s)
- Taskeen Mannan Sikora
- Dept. of Surgical Oncology, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra India
| | - Snita Sinukumar
- Dept. of Surgical Oncology, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra India
| | - Shailesh Naik
- Dept. of Surgical Oncology, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra India
| | - Nutan Jumle
- Dept. of Surgical Onco-Pathology, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra India
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Arif TB, Alabbas B, Vinayek R. Upper Gastrointestinal Bleeding Due to Metastatic Lung Adenocarcinoma in the Stomach and Duodenum. ACG Case Rep J 2024; 11:e01474. [PMID: 39176211 PMCID: PMC11340914 DOI: 10.14309/crj.0000000000001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/11/2024] [Indexed: 08/24/2024] Open
Abstract
There are very few reports of bloodborne metastasis of lung adenocarcinoma to the gastrointestinal tract, primarily due to poor prognosis and short survival rate of metastasized carcinoma. We present a case of a 79-year-old man with a medical history of lung adenocarcinoma, who presented with complaints of weakness and melena for 1 week. He had symptomatic anemia, for which he was transfused with blood. Esophagogastroduodenoscopy showed a 10 mm sessile polyp in the gastric body that was removed. One month later, the patient presented with a similar complaint, and another esophagogastroduodenoscopy revealed 2 ulcerated lesions in the second portion of the duodenum. These lesions were treated by hemostatic clip placement and heater probe coagulation. Biopsy of lesions demonstrated thyroid transcription factor 1 and Napsin-positive tumor cells, consistent with lung adenocarcinoma. Owing to the poor prognosis of lung adenocarcinoma metastasizing to the lymph nodes, stomach, and duodenum, the patient was transferred to hospice care.
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Affiliation(s)
- Taha Bin Arif
- Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD
| | - Bedoor Alabbas
- Department of Gastroenterology and Hepatology, Sinai Hospital of Baltimore, Baltimore, MD
| | - Rakesh Vinayek
- Department of Gastroenterology and Hepatology, Sinai Hospital of Baltimore, Baltimore, MD
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Nam JY, Lee JW, Kim JH, Jung M, Park MI, Moon W, Kim SE, Jung K, Park SJ. Direct gastric invasion from the liver metastasis of colorectal origin: A case report. Medicine (Baltimore) 2024; 103:e37732. [PMID: 38608071 PMCID: PMC11018212 DOI: 10.1097/md.0000000000037732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/06/2024] [Indexed: 04/14/2024] Open
Abstract
RATIONALE Colorectal cancer is the third most common cancer diagnosed worldwide. At the time of diagnosis of colorectal cancer, one of the most common metastatic sites is liver. Gastric metastasis from colorectal origin is rare. Moreover, a direct invasion of the stomach, by hepatic metastasis from colorectal cancer, is particularly uncommon. PATIENT CONCERNS A 56-year-old male patient with hematochezia was referred to our hospital. DIAGNOSIS The patient was diagnosed with unresectable colorectal cancer because of the presence of >10 metastases involving both lobes of the liver. INTERVENTIONS AND OUTCOMES After chemotherapy, the metastatic nodules in the liver nearly disappeared, except for a small nodule in segment VI. The patient underwent a radiofrequency ablation for the single lesion in the liver and laparoscopic low-anterior-resection for the primary tumor. Despite receiving various chemotherapy regimens, he experienced 6 recurrences, leading to 5 hepatectomies including a right hemi-hepatectomy, 1 pulmonary wedge resection, and 2 courses of radiation treatments. Lastly, a metastatic lesion in the liver was observed with invasion into the stomach. Subsequently, gastric wedge resection with resection of segments III and IV of the liver was performed. Direct invasion of the liver metastases into the stomach was confirmed histologically. LESSONS The patient is still alive, with a good quality of life, even after more than 8 years since the initial diagnosis. In the last instance of metastatic recurrence, direct invasion from the liver metastases into the stomach was observed, which is rare, and there are currently no reported cases.
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Affiliation(s)
- Jun Yeb Nam
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jung Wook Lee
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Jae Hyun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Minjung Jung
- Department of Pathology, Kosin University College of Medicine, Busan, South Korea
| | - Moo In Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Won Moon
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Kyoungwon Jung
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Seun Ja Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Hirano K, Nomura K, Ochiai Y, Hayasaka J, Suzuki Y, Mitsunaga Y, Odagiri H, Masui A, Kikuchi D, Hoteya S. Metastatic Gastric Tumors: Clinical and Endoscopic Features. Cureus 2024; 16:e58678. [PMID: 38770512 PMCID: PMC11103945 DOI: 10.7759/cureus.58678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Stomach metastasis is rare, and there are few reports on its endoscopic features. Herein, we focused on the endoscopic features and discussed and reviewed the clinicopathological characteristics of metastatic gastric tumors. METHODS We conducted an analysis on the clinicopathological features of individuals with gastric metastases originating from solid organ tumors at the Department of Gastroenterology, Toranomon Hospital, Minato-ku, Tokyo, Japan. Thirty-one cases were identified and evaluated for histology, initial presentation, endoscopic findings, lesion locations, treatment courses, and overall survival of the patients. RESULTS Endoscopic findings resembling submucosal tumors were present in five cases (16%), and those with a morphology similar to that of primary gastric cancer were present in 26 cases (84%). In addition, seven patients (22%) were diagnosed with gastric metastasis due to a suspected biopsy of early gastric cancer. Solitary metastasis (21 patients, 67.7%) was more common than multiple metastases (10 patients, 32.2%). The median time from primary tumor to diagnosis was 36 months, and survival after metastasis was 19 months. The overall survival (OS) after the diagnosis of the primary tumor was 22 months for esophageal cancer, 25 months for lung cancer, and 100 months for breast cancer, and the OS after the diagnosis of gastric metastasis was almost the same. The average time from the diagnosis of the primary tumor to the diagnosis of gastric metastasis (*timespan) was more than seven years for breast and kidney cancers. CONCLUSION As the prognosis of patients with cancer gradually improves, they develop metastases more frequently. Understanding the endoscopic findings and information about a patient's clinical history is useful to correctly diagnose gastric metastases.
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Affiliation(s)
| | | | | | | | - Yugo Suzuki
- Gastroenterology, Toranomon Hospital, Tokyo, JPN
| | | | | | - Akira Masui
- Gastroenterology, Toranomon Hospital, Tokyo, JPN
| | | | - Shu Hoteya
- Gastroenterology, Toranomon Hospital, Tokyo, JPN
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Wang Y, Yan C, Zhang C, Yu E, Wang K, Liu X, Yu J, Zhou C, Yang A. The disappearance of gastric metastasis and liver metastasis in non-small cell lung adenocarcinoma is due to osimertinib. J Cancer Res Clin Oncol 2023; 149:16069-16073. [PMID: 37695388 PMCID: PMC10620294 DOI: 10.1007/s00432-023-05386-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE Gastric metastasis of lung cancer is rare, and the cases of disappearance of gastric metastasis and liver metastasis caused by oxitinib treatment have not been reported. METHODS A 47-year-old male patient with no history of diabetes, hypertension or smoking presented with chest discomfort after eating. At the time of consultation, the diagnosis of adenocarcinoma of the right lower lobe of the lung with liver and gastric metastasis was considered by pathological examination of biopsy of the fundus of the stomach near the cardia, pathological examination of CT-guided lung aspiration and pathological examination of liver occupancy aspiration, combined with immunohistochemical results. He was found to have exon 19 deletion in next generation sequencing. We performed osimertinib on him (EGFR-TKI) systemic therapy, followed by local radiation therapy to the right lower lung primary lesion. RESULTS After systemic treatment with osimertinib and local radiotherapy of the primary site, the metastases disappeared and the primary site showed post-radiotherapy changes, and the evaluated efficacy was complete remission. CONCLUSIONS This is the first report to our knowledge of a patient who presented with gastric and hepatic metastases from lung cancer and achieved complete remission with osimertinib and local radiotherapy, with good quality of life, which also provides a basis for future clinical work and is of great significance.
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Affiliation(s)
- Yun Wang
- Department of Radiotherapy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China
| | - Chao Yan
- Department of Radiotherapy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China
| | - Chuantao Zhang
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266003, China
| | - Enhao Yu
- Department of Radiotherapy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China
| | - Kai Wang
- Department of Radiotherapy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China
| | - Xiangyong Liu
- Department of Radiotherapy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China
| | - Jie Yu
- Department of Radiotherapy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China
| | - Chunyang Zhou
- Department of Radiotherapy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China
| | - Aijie Yang
- Department of Radiotherapy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, 266035, Shandong, China.
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10
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Uchiyama T, Nakamura T, Nakata K, Adachi R, Hagi T, Asanuma K, Sudo A. Gastric metastasis in patients with leiomyosarcoma: A case report. Biomed Rep 2023; 19:75. [PMID: 37746592 PMCID: PMC10511945 DOI: 10.3892/br.2023.1657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/03/2023] [Indexed: 09/26/2023] Open
Abstract
Soft tissue sarcomas (STS) are very rare tumors, accounting for <1% of all malignancies. Leiomyosarcoma (LMS), accounts for 10-20% of STS. Gastric metastasis of LMS is extremely rare, and only a few cases have been reported. In the present report, two clinical cases of LMS with gastric metastasis. In the present cases, the metastases presented as a solitary lesion and was located in the upper body anterior wall in case 1, and body-greater curvature in case 2. It is debatable whether to perform any local treatment for gastric metastasis due to its poor prognosis. However, the progression of metastatic cancer in the stomach can lead to gastric bleeding, abdominal pain, and dysphagia, which may further shorten survival and decrease a patient's quality of life. Therefore, metastasectomy was performed in the present cases. This should be considered if digestive tract symptoms occur during the treatment of LMS.
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Affiliation(s)
- Teruya Uchiyama
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Tomoki Nakamura
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Kenta Nakata
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Ryohei Adachi
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Tomohito Hagi
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Kunihiro Asanuma
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
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11
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Da Cunha T, Restrepo D, Abi-Saleh S, Dharan M. Breast cancer metastasizing to the upper gastrointestinal tract (the esophagus and the stomach): A comprehensive review of the literature. World J Gastrointest Oncol 2023; 15:1332-1341. [PMID: 37663940 PMCID: PMC10473935 DOI: 10.4251/wjgo.v15.i8.1332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/01/2023] [Accepted: 07/05/2023] [Indexed: 08/10/2023] Open
Abstract
Breast cancer can infrequently metastasize to the upper gastrointestinal (GI) tract but the exact incidence is not well established-there is considerable variation between incidence reported from clinical studies and incidence noted in autopsy series. Clinical presentation can be very non-specific and often mimics primary gastrointestinal conditions. Endoscopy alone may not be sufficient to make a diagnosis and misdiagnosis is also common. A high degree of awareness and clinical suspicion is required to establish metastases to the upper GI tract. We undertook a comprehensive review of the available literature on breast cancer metastases to the esophagus and stomach including the clinical symptoms and presentation, endoscopic features, additional diagnostic imaging modalities, treatment and outcomes.
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Affiliation(s)
- Teresa Da Cunha
- Department of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT 06030, United States
| | - David Restrepo
- Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06030, United States
| | - Simon Abi-Saleh
- Department of Internal Medicine, University of Connecticut Health Center, Farmington, CT 06030, United States
| | - Murali Dharan
- Department of Gastroenterology and Hepatology, University of Connecticut Health Center, Farmington, CT 06030, United States
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12
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Khsiba A, Moalla M, Abid N, Douggaz A, Mahmoudi M, Mohamed AB, Yakoubi M, Medhioub M, Hamzaoui L, Chelbi E, Azzouz MM. A rare case of gastric metastasis originating from primary lung adenocarcinoma: a case report. Future Sci OA 2023; 9:FSO869. [PMID: 37485447 PMCID: PMC10357402 DOI: 10.2144/fsoa-2022-0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/15/2023] [Indexed: 07/25/2023] Open
Abstract
Unlike liver and lung, the stomach is rarely a metastatic location for cancers. We report a case of a 62-year-old man known to have lung adenocarcinoma poorly differentiated presented with melena 1 month after diagnosis. Upper endoscopy revealed an ulcerated tumor in the prepyloric antrum. The diagnosis of gastric metastasis from pulmonary cancer was confirmed by the immunohistochemical staining for the thyroid transcriptional factor-1 and the pattern cytokeratine CK7+/CK20-. In conclusion, gastric metastasis from primary lung cancer is a rare phenomenon that every clinician must keep in mind.
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Affiliation(s)
- Amal Khsiba
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Manel Moalla
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Narjes Abid
- Pulmonology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Amel Douggaz
- Pathology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Moufida Mahmoudi
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Asma Ben Mohamed
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Manel Yakoubi
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Mouna Medhioub
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Lamine Hamzaoui
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Emna Chelbi
- Pathology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
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Furukawa K, Hatakeyama K, Terashima M, Fujiya K, Tanizawa Y, Bando E, Sugino T, Urakami K, Naito T, Kagawa H, Yamaguchi K. Report of two patients in whom comparisons of the somatic mutation profile were useful for the diagnosis of metastatic tumors. Surg Case Rep 2022; 8:214. [DOI: 10.1186/s40792-022-01566-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
Abstract
Background
When a patient has multiple tumors in different organs, it is very important to identify whether the tumors are multiple cancers or metastasis from one tumor in order to establish an optimal treatment strategy. However, it is difficult to obtain an accurate diagnosis from conventional diagnostic strategies, including immunohistochemistry. We report two patients with multiple tumors in which a somatic mutation comparison using next-generation sequencing (NGS) was useful for the diagnosis of a metastatic tumor.
Case presentations
Patient 1: A 64-year-old man was diagnosed with gastric and lung cancer. After radical chemoradiotherapy for lung cancer, gastrectomy was planned for gastric cancer. At gastrectomy, the patient underwent a multiple omics analysis for “Project HOPE”. The gene mutational signature of the gastric tumor showed signature 4 of COSMIC mutational signature version 2, which was associated with smoking and has not been found in gastric cancer. To confirm that the gastric tumor was metastasis from lung cancer, we conducted a somatic mutation comparison of the two tumors with 409-gene panel sequencing, which revealed that 28 of 97 mutations in the lung tumor completely matched those of the gastric tumor. Based on these findings, the gastric tumor was diagnosed as metastasis from lung cancer. Patient 2: A 47-year-old woman underwent distal gastrectomy for gastric cancer. A colon tumor was detected 6 years after gastrectomy. The colon lesion was a submucosal tumor-like elevated tumor, and was suspected to be metastasis from gastric cancer. The patient underwent sigmoidectomy, and participated in “Project HOPE”. The possibility of primary colon cancer could not be ruled out, and we conducted a somatic mutation comparison of the two tumors as we did with Patient 1. Panel sequencing revealed 11 mutations in the gastric tumors, 4 of which completely matched those of the colon tumor. The colon tumor was diagnosed as metastasis from gastric cancer.
Conclusion
We reported two patients with multiple tumors in which a somatic mutation comparison using NGS was useful for the diagnosis of a metastatic tumor.
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Tanaka S, Yoshida R, Yoshizako T, Kitagaki H. Clinicoradiological Characteristics of Gastric Metastases: A Single Center Retrospective Study. Cureus 2022; 14:e30825. [DOI: 10.7759/cureus.30825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 11/05/2022] Open
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15
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Tang D, Lv J, Liu Z, Zhan S, Gao Y. Gastric Metastasis of Primary Lung Cancer: Case Report and Systematic Review With Pooled Analysis. Front Oncol 2022; 12:922016. [PMID: 35875072 PMCID: PMC9304872 DOI: 10.3389/fonc.2022.922016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/07/2022] [Indexed: 01/30/2023] Open
Abstract
BackgroundGastric metastasis from lung cancer (GMLC) is a rare occurrence. The clinicopathological characteristics, outcomes, and prognostic factors remain largely elusive.MethodsWe conducted a systematic review on case reports and case series of GMLC by scanning MEDLINE, Embase, and ISI Web of Knowledge. Data involving the clinicopathological features, treatment, and outcomes were extracted and analyzed. Survival analysis was performed using Kaplan–Meier method. The Cox proportional hazards regression model was used to identify potential prognostic factors associated with survival. Furthermore, a case of metastatic gastric adenocarcinoma of pulmonary origin with epidermal growth factor receptor (EGFR) L858R+T790M mutation was also described and included.ResultsSeventy-eight records involving 114 cases (including ours) were finally included. The median age on admission was 65 years with a male predominance of 79.8%. Lung adenocarcinoma (42.1%), located in the right upper lobe (30.3%), was the most frequent primary tumor. Bleeding (36.7%) and abdominal pain (35.8%) were the two most common symptoms. Endoscopically, gastric lesions were typically presented as elevated lesions with or without volcano-like ulceration, or ulcerative lesions, mostly involving the gastric corpus. The median overall survival time and survival time after diagnosis of metastatic cancer were 11 months [95% confidence interval (CI): 7–14] and 4.5 months (95% CI: 3–9), respectively. The survival analyses revealed that surgical interventions (including lung surgery and/or abdominal surgery) and systemic therapy (including chemotherapy, radiotherapy, and/or targeted therapy) seemed to be positive prognostic factors for both overall survival and survival after diagnosis of metastatic cancer.ConclusionsClinicians should be alerted to the occurrence of gastric metastasis in lung cancer patients. Comprehensive evaluation and appropriate treatment for specific patients may improve the survival rate of GMLC patients.
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Affiliation(s)
- Dong Tang
- Department of Gastroenterology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
| | - Jianjian Lv
- Department of Oncology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
| | - Zhijing Liu
- Department of Pathology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
| | - Shuhui Zhan
- Department of Gastroenterology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
| | - Yuqiang Gao
- Department of Gastroenterology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
- *Correspondence: Yuqiang Gao,
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16
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Vyas M, Hissong E, Gonzalez RS, Shia J, Jessurun J. Metastatic Neoplasms Involving the Stomach. Am J Clin Pathol 2022; 157:863-873. [PMID: 34875001 DOI: 10.1093/ajcp/aqab202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/22/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Metastatic neoplasms involving the stomach are rare and diagnostically challenging if clinical history of malignancy is absent or unavailable. This study was designed to identify the tumors that most frequently metastasize to the stomach and the morphologic features that can provide clues to investigate the possibility of metastasis and predict the primary sites. METHODS All patients with metastatic neoplasms involving the stomach were included in the study. The H&E- and immunohistochemical-stained slides were reviewed, and all clinical, endoscopic, and radiologic information was recorded. RESULTS One hundred fifty patients, including 84 (56%) women and 66 (44%) men (mean age, 64 years), were identified. Gastric metastases were the initial presentation in 15% cases. Epithelial tumors (73.3%) comprised the largest group, followed by melanoma (20.6%), sarcomas (4%), germ cell tumors (1.3%), and hematolymphoid neoplasms (0.7%). Lobular breast carcinoma was the most common neoplasm overall in women, while in men, it was melanoma. Solid/diffuse growth pattern (75%) was more common compared with glandular morphology. The solid/diffuse category included lobular breast carcinoma (21.3%), melanoma (20.6%), and renal cell carcinoma (10.6%), while the glandular category was dominated by gynecologic serous carcinomas (7.3%) with papillary/micropapillary architecture. CONCLUSIONS Metastatic neoplasms should be considered in the differential diagnosis of gastric neoplasms, particularly those with a diffuse/solid growth pattern. Glandular neoplasms are difficult to differentiate from gastric primaries except for Müllerian neoplasms, which frequently show a papillary/micropapillary architecture.
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Affiliation(s)
- Monika Vyas
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, MA , USA
- Department of Pathology, Memorial Sloan Kettering Cancer Center , New York, NY , USA
| | - Erika Hissong
- Department of Pathology, New York Presbyterian/Weill Cornell Medical Center , New York NY , USA
| | - Raul S Gonzalez
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, MA , USA
| | - Jinru Shia
- Department of Pathology, Memorial Sloan Kettering Cancer Center , New York, NY , USA
| | - Jose Jessurun
- Department of Pathology, New York Presbyterian/Weill Cornell Medical Center , New York NY , USA
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17
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Kaila V, Jain R, Lager DJ, Jensen P, Feldman M. Frequency of metastasis to the gastrointestinal tract determined by endoscopy in a community-based gastroenterology practice. Proc (Bayl Univ Med Cent) 2021; 34:658-663. [PMID: 34744302 DOI: 10.1080/08998280.2021.1936361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Metastasis to the gastrointestinal tract is rare. We performed a retrospective analysis to identify patients with metastatic disease to the gastrointestinal tract using two databases containing pathology results from all endoscopic procedures conducted by nearly 200 gastroenterologists in a community setting over a 14-year period. Forty-nine patients were diagnosed with metastasis to the gastrointestinal tract by endoscopy during the study period. Most were women (71%). The most common metastases to the gastrointestinal tract identified by endoscopy were breast cancers (n = 18), followed by melanomas (n = 12), ovarian cancers (n = 7), kidney cancers (n = 5), prostate cancers (n = 2), lung cancer (n = 1), and pancreatic cancer (n = 1). Three patients had unknown primary sites. Among women, the three leading known primary tumor sites were breast, ovary, and melanoma. Among men, the three leading primary tumor sites were melanoma, kidney, and prostate. The stomach was the most common portion of the gastrointestinal tract involved by metastases. Most affected women and were most frequently encountered in the stomach.
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Affiliation(s)
- Vishal Kaila
- Division of Gastroenterology, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas
| | - Rajeev Jain
- Department of Internal Medicine, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas.,Texas Digestive Disease Consultants, Dallas, Texas
| | | | - Pamela Jensen
- Department of Pathology, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas
| | - Mark Feldman
- Department of Internal Medicine, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas
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18
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Liu J, Xia L, Peng Y, Huang YS, Yang ZZ. Gastric metastasis and transformation of primary lung adenocarcinoma to small cell cancer after acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors: A case report. Medicine (Baltimore) 2021; 100:e27289. [PMID: 34596125 PMCID: PMC8483845 DOI: 10.1097/md.0000000000027289] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/19/2021] [Accepted: 09/02/2021] [Indexed: 01/30/2023] Open
Abstract
RATIONALE Transformation to small cell lung cancer (SCLC) is one of the mechanisms of resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). However, no standard treatment is available after the transformation. In addition, gastric metastasis of primary lung cancer is rarely observed; thus, little is known about its metastatic characteristics. PATIENT CONCERNS A 58-year-old male patient was treated with gefitinib (0.25 g /day) as the 1st line treatment due of recurrence after surgical resection for EGFR exon 19 mutation pulmonary adenocarcinoma. However, he experienced recurrence with positive T790 M, and osimertinib (80 mg/day) was administered as the 2nd line therapy. DIAGNOSIS One year and 6 months after osimertinib initiation, he complained of stomachache, and a diagnostic gastroscopy biopsy confirmed small cell lung cancer in the gastric body, indicating osimertinib-induced phenotypic transformation. INTERVENTIONS AND OUTCOMES The patient was treated with etoposide and platinum chemotherapy and maintenance therapy with osimertinib. Finally, the patient achieved a partial response after 4 cycles. LESSONS Timely second biopsies should be considered in the diagnosis of phenotypic transformation. After transformation, chemotherapeutic treatment with etoposide and platinum and maintenance therapy with osimertinib inhibited the progression of the disease.
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19
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Yang J, Yuan Y, Zhang S, Lv Y. Gastric metastasis from pancreatic cancer characterized by mucosal erosion: a case report and literature review. J Int Med Res 2021; 49:3000605211003759. [PMID: 33840245 PMCID: PMC8044569 DOI: 10.1177/03000605211003759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Pancreatic cancer with gastrointestinal tract metastasis is a fairly rare occurrence, and gastric metastasis in such cases has been seldom reported. We herein present a case of gastric involvement secondary to pancreatic cancer in a 74-year-old woman in whom the metastatic lesion only presented as mucosal erosion in the stomach. The patient had a 1-month history of progressive right upper quadrant pain before admission. Computed tomography and endoscopic examinations revealed a solid and hypo-enhancing mass in the head of the pancreas. The patient underwent conventional upper endoscopy before pancreatic biopsy, and mucosal erosion was observed in the gastric pylorus. We obtained gastric and pancreatic biopsies by gastroscopy and endoscopic ultrasound-guided fine needle aspiration, respectively. Pathologically, the biopsies taken from the area of gastric erosion showed poorly differentiated invasive adenocarcinoma that was morphologically consistent with the pancreatic specimens. Moreover, the gastric section showed tumor thrombi within the vessels. Hence, the suspected diagnosis was unresectable pancreatic cancer with gastric metastasis. The patient immediately underwent two courses of chemotherapy, but her condition rapidly deteriorated and she died 2 months later.
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Affiliation(s)
- Jie Yang
- Department of Gastroenterology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yue Yuan
- Department of Gastroenterology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shu Zhang
- Department of Gastroenterology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China
| | - Ying Lv
- Department of Gastroenterology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Gastroenterology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China
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20
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A rare case of gallbladder cancer with multiple metastases to the colon. Clin J Gastroenterol 2021; 14:608-612. [PMID: 33386564 DOI: 10.1007/s12328-020-01301-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
Gallbladder cancer is often diagnosed with metastasis and is known to have poor prognosis. Although, gallbladder cancer often metastasizes to liver, lung, or lymph nodes, metastasis to gastrointestinal tract is not common. Several autopsy studies reported colorectal metastasis from gallbladder cancer, but most of these cases were supposed to be gastrointestinal invasion from peritoneal dissemination. We experienced a rare case of hematogenous colon metastasis from gallbladder cancer. Colonoscopy for a 76-year-old man who was diagnosed as gallbladder cancer revealed two 5-mm flatly elevated lesions with central erosion in the transverse and sigmoid colon. Endoscopic mucosal resection (EMR) revealed poorly differentiated adenocarcinoma in hematoxylin and eosin staining. Additional immunohistochemistry examination showed strongly positive CK7 expression with negative CDX2, and suggested colon metastases from gallbladder cancer. Despite the positive vertical margin in EMR specimens, autopsy finding denied colorectal invasion from peritoneal dissemination and proved vascular spread colon metastases. Gastrointestinal metastasis is often misdiagnosed as a primary tumor, and thus, it is important to recognize gallbladder cancer as a potential origin of gastrointestinal metastasis.
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21
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Geada L, Kantor M, Mohan K, Weingrad D, Nasiff LS. An Uncommon Presentation of a Common Disease: A Review of Gastric Metastasis From Breast Carcinoma. Cureus 2020; 12:e11920. [PMID: 33425505 PMCID: PMC7785476 DOI: 10.7759/cureus.11920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Breast cancer is the most common cancer in women, and the leading cause of cancer-related deaths worldwide. Despite advances in screening and treatment modalities, distant metastasis still develops. Breast cancer metastasis to the gastrointestinal tract is very rare, therefore, its diagnosis, therapeutic strategies, and prognosis pose a clinical problem for clinicians. We summarize the current knowledge regarding the clinicopathological characteristics and diagnostic strategies for metastatic tumors in the stomach of breast origin.
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Affiliation(s)
- Luis Geada
- Department of General Surgery, Aventura Hospital and Medical Center, Miami, USA.,Department of General Surgery, Kendall Regional Medical Center, Miami, USA
| | - Micaella Kantor
- Department of Gastroenterology, Palm Springs Hospital, Miami, USA
| | - Karthik Mohan
- Department of Gastroenterology, Palmetto General Hospital, Miami, USA
| | - Daniel Weingrad
- Department of Surgical Oncology, Aventura Hospital and Medical Center, Miami, USA
| | - Luis S Nasiff
- Department of Gastroenterology, Palm Springs Hospital, Miami, USA
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22
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Oriuchi M, Uno K, Fujishima F, Takeuchi A, Lee S, Hatta W, Asano N, Koike T, Imatani A, Masamune A. A rare case of gastric squamous-cell carcinoma metastasized from the cervix. Clin J Gastroenterol 2020; 13:1062-1065. [PMID: 32712841 DOI: 10.1007/s12328-020-01191-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
Gastric squamous-cell carcinoma (SqCC) metastasized form the cervix is rarely detected in endoscopic examination, although cervical carcinoma is the second most common in gynecologic malignancy. A 59-year-old female visited a clinic for anorexia, and an esophago-gastro-duodenoscopy (EGD) revealed multiple submucosal tumors (SMTs) of the stomach. After she was referred, an image-enhanced endoscopy enhanced multiple SMTs with white spots, whose findings were irregular micro-vascular patterns in the mucosa with irregular/absent micro-surface pattern. We took endoscopic biopsies, whose histological diagnoses were SqCC in the layer of the lamina propria under normal epithelium. Positron emission tomography-CT, CT and magnetic resonance imaging revealed an irregularly enhanced mass of the cervix, the irregularly thickening wall of the stomach and peritoneal nodules. Palliative care alone was administered based on poor condition associated with the Stage IV cervical carcinoma. In this case, endoscopic detection of gastric SqCC might provide a tip to make final diagnosis of primary site of cervical SqCC. The numbers of endoscopic examination become increasing, so further deep awareness of such patterns of metastasis in cervical cancer are required.
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Affiliation(s)
- Masayoshi Oriuchi
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan.
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Kaname Uno
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan.
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Fumiyoshi Fujishima
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akio Takeuchi
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sujae Lee
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Waku Hatta
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naoki Asano
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoyuki Koike
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Imatani
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atushi Masamune
- Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
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23
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Kutasovic JR, McCart Reed AE, Sokolova A, Jayanthan J, Da Silva L, Simpson PT, Lakhani SR. Phenotypic drift in metastatic progression of breast cancer: A case report with histologically heterogeneous lesions that are clonally related. Clin Case Rep 2020; 8:2725-2731. [PMID: 33363813 PMCID: PMC7752647 DOI: 10.1002/ccr3.3257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 07/21/2020] [Accepted: 08/01/2020] [Indexed: 11/22/2022] Open
Abstract
Breast cancer metastasis to the stomach is rare; invasive lobular carcinoma has a predilection to spread to the gastrointestinal system and is morphologically similar to primary diffuse gastric carcinoma. This case highlights heterogeneous metastatic progression and that documentation of heterogeneity is important for informing future treatment strategies and prognostication.
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Affiliation(s)
- Jamie R. Kutasovic
- UQ Centre for Clinical Research, Faculty of MedicineThe University of QueenslandBrisbaneQldAustralia
| | - Amy E. McCart Reed
- UQ Centre for Clinical Research, Faculty of MedicineThe University of QueenslandBrisbaneQldAustralia
| | - Anna Sokolova
- UQ Centre for Clinical Research, Faculty of MedicineThe University of QueenslandBrisbaneQldAustralia
- Pathology QueenslandThe Royal Brisbane and Women’s HospitalBrisbaneQldAustralia
| | - Janani Jayanthan
- UQ Centre for Clinical Research, Faculty of MedicineThe University of QueenslandBrisbaneQldAustralia
| | - Leonard Da Silva
- UQ Centre for Clinical Research, Faculty of MedicineThe University of QueenslandBrisbaneQldAustralia
- Pathology QueenslandThe Royal Brisbane and Women’s HospitalBrisbaneQldAustralia
| | - Peter T. Simpson
- UQ Centre for Clinical Research, Faculty of MedicineThe University of QueenslandBrisbaneQldAustralia
| | - Sunil R. Lakhani
- UQ Centre for Clinical Research, Faculty of MedicineThe University of QueenslandBrisbaneQldAustralia
- Pathology QueenslandThe Royal Brisbane and Women’s HospitalBrisbaneQldAustralia
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24
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Picchio M, Paioletti A, Santini E, Iacoponi S, Cordahi M. Gastric Metastasis from Renal Cell Carcinoma Fourteen Years after Radical Nephrectomy. Acta Chir Belg 2020. [DOI: 10.1080/00015458.2000.12098550] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- M. Picchio
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
| | - A. Paioletti
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
| | - E. Santini
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
| | - S. Iacoponi
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
| | - M. Cordahi
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
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25
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Nemoto M, Prasoon P, Ichikawa H, Hanyu T, Kano Y, Muneoka Y, Usui K, Hirose Y, Miura K, Shimada Y, Nagahashi M, Sakata J, Ishikawa T, Tsuchida M, Wakai T. Primary lung squamous cell carcinoma and its association with gastric metastasis: A case report and literature review. Thorac Cancer 2020; 11:1708-1711. [PMID: 32212371 PMCID: PMC7262906 DOI: 10.1111/1759-7714.13410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 11/27/2022] Open
Abstract
Nearly 50% of primary lung carcinoma patients present with distant metastasis at their first visit. However, gastrointestinal tract (GIT) metastasis is an infrequent impediment. Herein, we report a case of progressive dysphagia and epigastralgia as an initial manifestation of recurrence as gastric metastasis of primary lung squamous cell carcinoma (SCC) after curative surgery. A 64-year-old man was diagnosed with primary lung SCC of the right lower lobe, and underwent thoracoscopic lower lobectomy. One year after lobectomy, computed tomography (CT) scan showed a gastric fundal mass located in the gastric cardia which measured 5 cm. Endoscopic biopsies and histopathology subsequently confirmed that tumor was SCC. The patient then underwent proximal gastrectomy with resection of the diaphragmatic crus. Following surgery, histopathological examination revealed gastric metastasis from primary lung SCC. KEY POINTS: Gastric metastasis of primary lung carcinoma is one of the rarest phenomena. Gastrointestinal symptoms should raise suspicion of the presence of advanced metastatic disease with poor prognosis.
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Affiliation(s)
- Mariko Nemoto
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Pankaj Prasoon
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Hiroshi Ichikawa
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Takaaki Hanyu
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Yosuke Kano
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Yusuke Muneoka
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Kenji Usui
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Yuki Hirose
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Kohei Miura
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Yoshifumi Shimada
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Masayuki Nagahashi
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Jun Sakata
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Takashi Ishikawa
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Masanori Tsuchida
- Division of Thoracic and Cardiovascular SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Toshifumi Wakai
- Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
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26
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Kinoshita O, Dohi M, Horii Y, Ikai A, Kitamori T, Yamashita T. Simultaneous resection of gastric and gallbladder metastasis from renal cell carcinoma treated by laparoscopic and endoscopic cooperative surgery: a case report. Surg Case Rep 2019; 5:17. [PMID: 30715627 PMCID: PMC6364323 DOI: 10.1186/s40792-019-0569-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/16/2019] [Indexed: 12/13/2022] Open
Abstract
Background Metastases to the stomach or gallbladder from any malignancy is rarely noted, and simultaneous metastases to both organs are atypical. We present a unique case of simultaneous multifocal metastases of the stomach and gallbladder from renal cell carcinoma (RCC). Case presentation The case involved a 60-year-old man, with a past history of RCC (clear cell type, G2, T1b N0 M0 Stage I) treated by a right nephrectomy. Three years after the nephrectomy, a routine gastrointestinal endoscopy found an ulcerative lesion in the greater curvature of the gastric body. The gastric tumor was pathologically proven to be a metastasis from RCC. Furthermore, computed tomography incidentally revealed a mass lesion in the fundus of the gallbladder, which was also diagnosed as a potential metastasis from RCC. As endoscopic ultrasonography of the gastric tumor suggested the tumor potentially invaded to the submucosal layer, gastric wedge resection via a laparoscopic and endoscopic cooperative surgery (LECS) technique was applied to the gastric tumor, and laparoscopic cholecystectomy to the gallbladder tumor was simultaneously performed. Histological examination confirmed that the tumors of the stomach and gallbladder were both metastatic RCC. The hospitalization period after surgery was not eventful, and the patient was discharged on postoperative day 7. Thereafter, the patient required examination every 3 months, did not use anticancer agents, and has survived without relapse to 9 months after the surgery. Conclusions For patients with locally resectable RCC metastases, complete metastasectomy may bring long-term tumor control. Moreover, LECS for gastric metastasis is a reasonable approach for minimal invasiveness and an oncologically feasible outcome.
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Affiliation(s)
- Osamu Kinoshita
- Department of Surgery, Maizuru Medical Center, Kyoto, Japan.
| | - Moyu Dohi
- Department of Gastroenterology, Maizuru Medical Center, Kyoto, Japan
| | - Yusuke Horii
- Department of Gastroenterology, Maizuru Medical Center, Kyoto, Japan
| | - Atsushi Ikai
- Department of Surgery, Maizuru Medical Center, Kyoto, Japan
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Ray S, Yadav A, Jain S, Nundy S. Isolated antro-pyloric metastatic mass from colonic carcinoma: A rare case presentation. Ann Med Surg (Lond) 2018; 36:235-238. [PMID: 30519465 PMCID: PMC6260385 DOI: 10.1016/j.amsu.2018.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 10/30/2018] [Accepted: 11/06/2018] [Indexed: 11/28/2022] Open
Abstract
Metastatic tumors to stomach are extremely rare with very few cases being described so far in the surgical literature. Colonic tumors metastatic to stomach represent a rarer entity and present a surgical challenge for diagnosis and management to the clinician. We, hereby present a case of adenocarcinoma of transverse colon metastatic to stomach more than 6 years after the index malignancy, presenting clinically with features of gastric outlet obstruction. It was treated with open subtotal gastrectomy, with diagnosis being made on histopathologic examination using special immunochemical stains. Adjuvant treatment in the form of chemotherapy was given and follow up cross sectional imaging showed no evidence of residual disease so far.
Extreme rarity of this pathological entity. Diagnostic challenges faced in such a clinical scenario. Forming a very rare and interesting differential diagnosis of gastric outlet obstruction. First case reported to present 6 years after the index colonic primary.
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Affiliation(s)
- Samrat Ray
- Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India
- Corresponding author. Room no. 1470, Old Building, 4th floor, Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi, 110060, India.
| | - Amitabh Yadav
- Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India
| | - Sunila Jain
- Department of Histopathology, Sir Ganga Ram Hospital, India
| | - Samiran Nundy
- Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India
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28
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Güler SA, Şimşek T, Pösteki G, Güreşin A, Çınar S, Onbaşılar U, Cantürk NZ. A Very Rare Reason for Gastric Perforation, Caused by Gastric Metastasis of Breast Cancer: Case Presentation. Eur J Breast Health 2018; 15:59-62. [PMID: 30816356 DOI: 10.5152/ejbh.2018.4285] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/02/2018] [Indexed: 12/28/2022]
Abstract
Breast cancer is the mostly seen malignancy of women. Breast cancer causes lung, bone, liver and brain metastasis. On the other hand, gastric metastasis of breast cancer is a rarely seen metastasis. For this reason, it may be misdiagnosed or diagnosed after its morbid or mortal complications occurred. This may also result as a delay of breast cancers primary treatment. If occurred the best tool is immunohistochemical panels especially gross cystic disease fluid protein 15 (GCDFP-15) for exact diagnosis. In our case, a gastric metastasis of breast cancer is presented which was admitted with the acute abdominal findings caused by its result as gastric perforation and diagnosed by GCDFP-15 immunohistochemical panel.
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Affiliation(s)
- Sertaç Ata Güler
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Turgay Şimşek
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Gökhan Pösteki
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Alican Güreşin
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Saffet Çınar
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Umut Onbaşılar
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Nuh Zafer Cantürk
- Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey
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Secondary tumors of the GI tract: origin, histology, and endoscopic findings. Gastrointest Endosc 2018; 88:151-158.e1. [PMID: 29476848 DOI: 10.1016/j.gie.2018.02.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 02/15/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The GI tract is rarely affected by secondary tumors. Patients often present at an advanced stage of the disease, and prognosis is dismal. This study aimed to analyze the clinical, endoscopic, and pathologic features of secondary tumors that had been diagnosed endoscopically. METHODS We conducted a retrospective database analysis of 217 patients with secondary tumors of the GI tract. Endoscopic findings and histologic diagnoses were systematically re-evaluated. RESULTS Malignant melanoma (n = 33, 15%), breast cancer (n = 32, 15%), and pancreatic cancer (n = 27, 12%) were the most common corresponding primaries. About one-third of secondary tumors were detected in the stomach (n = 76, 35%), followed by small intestine (n = 54, 25%) and rectum (n = 53, 24%). The median time between the diagnoses of primary and secondary tumors was 19 months (mean, 31; range, 0-251), and this time was particularly long for renal cell carcinoma and breast cancer (median, 38 and 45 months, respectively). Direct invasion from extra-GI malignancies was more common (56%) than vascular cancer spread (44%) and depended on both sites of tumor involvement and corresponding primary. The lesions presented with various endoscopic patterns. In patients for whom a definitive diagnosis of cancer was known before the examination (n = 168), a secondary tumor was included in the differential diagnosis in only 48% of lesions. It is of note that the remaining cases were diagnosed endoscopically as primary tumors and rarely also as nonneoplastic change. CONCLUSIONS Secondary tumors may affect all parts of the GI tract. Malignant melanoma and breast and pancreatic cancer represent the most common primaries. Diagnosis based on examination of biopsy specimens is crucial to avoid misclassification.
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30
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Cascinu S, Luzi Fedeli S, Fedeli A, Catalano G. Gastric Metastases from Breast Cancer: A Case Report. TUMORI JOURNAL 2018; 75:150-1. [PMID: 2741221 DOI: 10.1177/030089168907500214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We describe a case of a 50 year old woman with a secondary involvement of the stomach from breast carcinoma. She complained of nausea, vomiting and epigastric pain resistant to gastroprotective drugs. Initially symptoms were attributed to the side effects of chemotherapeutic agents. Correct diagnosis led to effective treatment of gastrointestinal symptoms with consequent improvement in her quality of life.
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Affiliation(s)
- S Cascinu
- Servizio di Oncologia, Ospedali Riuniti Pesaro, Italy
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31
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Nitipir C, Ginghina O, Popa L, Andrei F, Tudor N, Radu I, Iaciu C, Orlov C, Vasilescu F, Balalau C, Leon G, Negrei C, Barbu MA. A rare case of advanced lung cancer presenting as a symptomatic gastric tumor. Mol Clin Oncol 2018. [PMID: 29541469 DOI: 10.3892/mco.2018.1565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Although gastric metastases have been estimated to occur in less than 2% of cancer patients, an increased use of upper digestive tract endoscopy allows for a higher detection of secondary gastric tumors. We describe the case of a 66-year-old male patient presenting with mild pain in the sternum and upper abdominal area. Physical examination revealed a right parietal skull tumor, with no other significant clinical changes. Upon exclusion of an acute coronary syndrome, upper digestive tract endoscopy was performed, showing the presence of an ulcerated tumor located in the gastric fundus. Histopathologic examination of the biopsy sample and immunohistochemical tests suggested a pulmonary origin of the gastric tumor. Whole body computer tomography showed the presence of tumors in the gastric fundus, left lung, liver, kidneys, bones and brain. Transbronchial biopsy of the lung tumor certified the diagnosis of non-small cell lung cancer, with the same immunohistochemical profile as the gastric tumor. Hence, it was considered the origin of the metastases. Biopsy of the skull tumor also had the identical tumor histology. Whole brain radiotherapy was performed for the brain metastases and subsequent chemotherapy was administered. Although non-specific, gastrointestinal signs and symptoms occurring in lung cancer patients should alert the clinicians as to the possibility of gastrointestinal metastases and prompt endoscopic evaluation.
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Affiliation(s)
- Cornelia Nitipir
- Department of Oncology, Elias University Clinical Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 011461 Bucharest, Romania
| | - Octav Ginghina
- Department of Surgery, 'Sf. Ioan' Clinical Emergency Hospital, Carol Davila University, Faculty of Dental Medicine, 042122 Bucharest, Romania
| | - Liliana Popa
- Department of Dermatology, Elias University Clinical Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 011461 Bucharest, Romania
| | - Florin Andrei
- Department of Histopathology, Elias University Clinical Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 011461 Bucharest, Romania
| | - Nicolaie Tudor
- Department of Gastroenterology, Elias University Clinical Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 011461 Bucharest, Romania
| | - Irina Radu
- Department of Oncology, Elias University Clinical Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 011461 Bucharest, Romania
| | - Cristian Iaciu
- Department of Oncology, Elias University Clinical Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 011461 Bucharest, Romania
| | - Cristina Orlov
- Department of Oncology, Elias University Clinical Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 011461 Bucharest, Romania
| | - Florina Vasilescu
- Department of Pathology, Emergency University Military Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 020021 Bucharest, Romania
| | - Cristian Balalau
- Department of Surgery, 'Sf. Pantelimon' Clinical Emergency Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 021659 Bucharest, Romania
| | - Grigoris Leon
- Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, Medical School, 10679 Athens, Greece
| | - Carolina Negrei
- Department of Toxicology, Faculty of Pharmacy, 'Carol Davila' University of Medicine and Pharmacy, 020956 Bucharest, Romania
| | - Maria Alexandra Barbu
- Department of Oncology, Elias University Clinical Hospital, Carol Davila University, Medicine and Pharmacy Faculty, 011461 Bucharest, Romania
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Yim K, Ro SM, Lee J. Breast cancer metastasizing to the stomach mimicking primary gastric cancer: A case report. World J Gastroenterol 2017; 23:2251-2257. [PMID: 28405154 PMCID: PMC5374138 DOI: 10.3748/wjg.v23.i12.2251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/24/2017] [Accepted: 03/02/2017] [Indexed: 02/06/2023] Open
Abstract
Breast cancer with stomach metastasis rare with an incidence of 1% or less among metastatic breast cancer patients. We experienced a case of breast cancer metastasizing to the stomach in 65-year-old female patient. She experienced dyspepsia and poor oral intake before visiting the clinic. Diffuse infiltration with nodular mucosal thickening of the stomach wall was observed, suggesting advanced gastric cancer based on gross endoscopic finding. Spread of poorly cohesive tumor cells in the gastric mucosa observed upon hematoxylin and eosin stain resembled signet ring cell carcinoma, but diffuse positive staining for GATA3 in immunohistochemical stain allowed for a conclusive diagnosis of breast cancer metastasizing to the stomach. Based on the final diagnosis, systemic chemotherapy was administered instead of primary surgical resection. After 2 cycles of docetaxel administration, she showed a partial response based on abdominal computed tomography scan. This case is an unusual presentation of breast cancer metastasizing to the gastrointestinal tract.
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33
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Gastric Metastases from Lung Adenocarcinoma Causing Gastrointestinal Bleeding. ACG Case Rep J 2017; 4:e25. [PMID: 28286791 PMCID: PMC5340659 DOI: 10.14309/crj.2017.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 12/08/2016] [Indexed: 12/16/2022] Open
Abstract
Metastases to the stomach are rare. They are commonly asymptomatic, and the diagnosis is usually established during autopsy. We present a patient known to have stage IV lung adenocarcinoma who presented with melena and shock. Endoscopy revealed multiple gastric nodules, which were proved to be metastatic deposits from her lung cancer. The possibility of gastric metastases should be kept in mind in patients presenting with gastrointestinal bleeding. Endoscopy and biopsy remain the gold standard for diagnostic testing in such patients.
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34
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Zullo A, Balsamo G, Lorenzetti R, Romiti A, De Francesco V, Hassan C, Manta R. Gastric metastases from gynaecologic tumors: case reports and review of the literature. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:483. [PMID: 28149845 DOI: 10.21037/atm.2016.12.51] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The stomach is an infrequent localization of tumor metastases, and metastases originating from primary gynaecological cancers are particularly rare. We described the case of three females with ovarian, uterine, and breast metastases in the stomach, and we performed a systematic review of the literature of cases diagnosed at endoscopy. Overall, data of 18 patients with gastric metastases originating from the ovary, 11 from the uterus, and 159 from breast cancer were analyzed. Therefore, gastric metastasis mainly occurs from breast cancer, whilst both ovarian and uterine metastases are distinctly less frequent, but not impossible.
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Affiliation(s)
- Angelo Zullo
- Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | | | | | - Adriana Romiti
- Oncology Unit, Sant'Andrea University Hospital, Rome, Italy
| | | | - Cesare Hassan
- Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Raffaele Manta
- Gastroenterology Unit, Nuovo Ospedale Civile Sant'Agostino-Estense, Baggiovara-Modena, Italy
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35
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Costa M, Ivanova E, Esteves J. Upper gastrointestinal bleeding due to gastric metastasis from a primary uterine leiomyosarcoma. Acta Clin Belg 2016; 71:271-2. [PMID: 26400663 DOI: 10.1179/2295333715y.0000000071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Mariana Costa
- a Gastroenterology Department , Centro Hospitalar de Lisboa Central , Portugal
| | - Ekaterina Ivanova
- b Pathology Department , Centro Hospitalar Barreiro Montijo , Portugal
| | - Jorge Esteves
- c Gastroenterology Department , Centro Hospitalar Barreiro Montijo , Portugal
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36
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Mazumdar S, Sundaram S, Patil P, Mehta S, Ramadwar M. A rare case of metastatic germ cell tumor to stomach and duodenum masquerading as signet ring cell adenocarcinoma. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:309. [PMID: 27668229 PMCID: PMC5009030 DOI: 10.21037/atm.2016.08.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 07/19/2016] [Indexed: 01/14/2023]
Abstract
Adenocarcinomas are the most common cancers affecting stomach. However gastrointestinal stromal tumors (GIST), lymphomas and neuroendocrine tumors (NETs) can also affect the stomach. But stomach is relatively rare site of involvement by metastasis. In this case report a rare metastasis of germ cell tumor (GCT) into stomach is described which clinically and endoscopically masquerade as primary gastric cancers. But detailed clinical examination and vigilant histopathological reporting proves the origin of tumor distant from stomach and thereby change the whole approach of management.
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37
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Wong CS, Gumber A, Kiruparan P, Blackmore A. Gastric perforation secondary to metastasis from breast cancer. BMJ Case Rep 2016; 2016:bcr-2016-214865. [PMID: 27435841 DOI: 10.1136/bcr-2016-214865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Gastric perforation secondary to metastasis from breast cancer occurs infrequently. We present the case of a 72-year-old postmenopausal female patient with a known history of lobular carcinoma of the breast who presented to a district general hospital with a clinical diagnosis of an acute abdomen. Further contrast-enhanced CT scan demonstrated free gas and fluid in the abdomen. She underwent emergency exploratory laparotomy and onlay Graham's omentopexy patch due to 1×1 cm prepyloric gastric perforation. Final histopathology proved the presence of metastatic malignant cells in the breast origin. We discuss the issues involved in postoperative investigation and management.
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Affiliation(s)
| | - Ashutosh Gumber
- Department of General Surgery, Blackpool Victoria Hospital, Blackpool, UK
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38
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El-Hage A, Ruel C, Afif W, Wissanji H, Hogue JC, Desbiens C, Leblanc G, Poirier É. Metastatic pattern of invasive lobular carcinoma of the breast-Emphasis on gastric metastases. J Surg Oncol 2016; 114:543-547. [PMID: 27406466 DOI: 10.1002/jso.24362] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/28/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Breast invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) have different metastatic patterns, but the exact pattern of metastases from ILC is poorly known. This study aimed to determine the frequency of ILC metastases in atypical locations, with an emphasis on gastric metastases. METHODS Patients with ILC treated at the Saint-Sacrement Hospital (Quebec City, Canada) and the Maisonneuve-Rosemont Hospital (Montreal, Canada) between January 2003 and December 2009 were retrospectively reviewed. Demographic, clinical, and follow-up data were retrieved from the medical charts. Metastases that were diagnosed during follow-up were recorded. RESULTS Among the 481 patients with ILC, 74 (15.4%) were diagnosed with metastases after a median follow-up of 46 months. Among these 74 patients, 41.9% had metastases in atypical sites. Five patients were diagnosed with histologically confirmed gastric metastases of ILC. CONCLUSION Metastases of breast ILC to atypical sites might be more frequent than previously reported. Clinicians should keep a high level of suspicion when a patient with a history of ILC develops digestive symptoms. It is important to differentiate metastases from a primary GI tumor by using immunohistochemical markers. J. Surg. Oncol. 2016;114:543-547. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ali El-Hage
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada
| | - Carolanne Ruel
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada
| | - Wahiba Afif
- Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada
| | - Hussein Wissanji
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada
| | - Jean-Charles Hogue
- Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada.,Centre des Maladies du Sein Deschênes-Fabia, CHU de Québec-Université Laval, Québec, Québec, Canada.,Axe Oncology, Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Christine Desbiens
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada.,Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada.,Centre des Maladies du Sein Deschênes-Fabia, CHU de Québec-Université Laval, Québec, Québec, Canada.,Axe Oncology, Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Guy Leblanc
- Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada
| | - Éric Poirier
- Faculté de Médecine, Département de Chirurgie, Université Laval, Cité Universitaire, Québec, Québec, Canada. .,Faculté de Médecine, Département de Chirurgie, Université de Montréal, Montréal, Québec, Canada. .,Centre des Maladies du Sein Deschênes-Fabia, CHU de Québec-Université Laval, Québec, Québec, Canada. .,Axe Oncology, Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.
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Thura M, Al-Aidaroos AQO, Yong WP, Kono K, Gupta A, Lin YB, Mimura K, Thiery JP, Goh BC, Tan P, Soo R, Hong CW, Wang L, Lin SJ, Chen E, Rha SY, Chung HC, Li J, Nandi S, Yuen HF, Zhang SD, Guan YK, So J, Zeng Q. PRL3-zumab, a first-in-class humanized antibody for cancer therapy. JCI Insight 2016; 1:e87607. [PMID: 27699276 DOI: 10.1172/jci.insight.87607] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Novel, tumor-specific drugs are urgently needed for a breakthrough in cancer therapy. Herein, we generated a first-in-class humanized antibody (PRL3-zumab) against PRL-3, an intracellular tumor-associated phosphatase upregulated in multiple human cancers, for unconventional cancer immunotherapies. We focused on gastric cancer (GC), wherein elevated PRL-3 mRNA levels significantly correlated with shortened overall survival of GC patients. PRL-3 protein was overexpressed in 85% of fresh-frozen clinical gastric tumor samples examined but not in patient-matched normal gastric tissues. Using human GC cell lines, we demonstrated that PRL3-zumab specifically blocked PRL-3+, but not PRL-3-, orthotopic gastric tumors. In this setting, PRL3-zumab had better therapeutic efficacy as a monotherapy, rather than simultaneous combination with 5-fluorouracil or 5-fluorouracil alone. PRL3-zumab could also prevent PRL-3+ tumor recurrence. Mechanistically, we found that intracellular PRL-3 antigens could be externalized to become "extracellular oncotargets" that serve as bait for PRL3-zumab binding to potentially bridge and recruit immunocytes into tumor microenvironments for killing effects on cancer cells. In summary, our results document a comprehensive cancer therapeutic approach to specific antibody-targeted therapy against the PRL-3 oncotarget as a case study for developing antibodies against other intracellular targets in drug discovery.
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Affiliation(s)
- Min Thura
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | | | - Wei Peng Yong
- Department of Haematology-Oncology, National University Cancer Institute, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Koji Kono
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Division of General Surgery (Upper Gastrointestinal Surgery), National University Hospital, Singapore
| | - Abhishek Gupta
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - You Bin Lin
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Kousaku Mimura
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Jean Paul Thiery
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Boon Cher Goh
- Department of Haematology-Oncology, National University Cancer Institute, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Patrick Tan
- Genome Institute of Singapore, A*STAR, Singapore
| | - Ross Soo
- Department of Haematology-Oncology, National University Cancer Institute, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | | | - Lingzhi Wang
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | | | - Elya Chen
- Division of General Surgery (Upper Gastrointestinal Surgery), National University Hospital, Singapore
| | - Sun Young Rha
- Department of Internal Medicine, Yonsei Cancer Research Institute, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyun Cheol Chung
- Department of Internal Medicine, Yonsei Cancer Research Institute, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Jie Li
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Sayantani Nandi
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Hiu Fung Yuen
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Shu-Dong Zhang
- Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC, Londonderry, United Kingdom
| | - Yeoh Khay Guan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jimmy So
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Surgical Oncology (Upper Gastrointestinal Surgery), National University Cancer Institute, Singapore
| | - Qi Zeng
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
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Kim GH, Ahn JY, Jung HY, Park YS, Kim MJ, Choi KD, Lee JH, Choi KS, Kim DH, Lim H, Song HJ, Lee GH, Kim JH. Clinical and Endoscopic Features of Metastatic Tumors in the Stomach. Gut Liver 2016; 9:615-22. [PMID: 25473071 PMCID: PMC4562778 DOI: 10.5009/gnl14032] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background/Aims Metastasis to the stomach is rare. The aim of this study was to describe and analyze the clinical outcomes of cancers that metastasized to the stomach. Methods We reviewed the clinicopathological aspects of patients with gastric metastases from solid organ tumors. Thirty-seven cases were identified, and we evaluated the histology, initial presentation, imaging findings, lesion locations, treatment courses, and overall patient survival. Results Endoscopic findings indicated that solitary lesions presented more frequently than multiple lesions and submucosal tumor-like tumors were the most common appearance. Malignant melanoma was the tumor that most frequently metastasized to the stomach. Twelve patients received treatments after the diagnosis of gastric metastasis. The median survival period from the diagnosis of gastric metastasis was 3.0 months (interquartile range, 1.0 to 11.0 months). Patients with solitary lesions and patients who received any treatments survived longer after the diagnosis of metastatic cancer than patients with multiple lesions and patients who did not any receive any treatments. Conclusions Proper treatment with careful consideration of the primary tumor characteristics can increase the survival period in patients with tumors that metastasize to the stomach, especially in cases with solitary metastatic lesions in endoscopic findings.
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Affiliation(s)
- Ga Hee Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Ji Yong Ahn
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Hwoon-Yong Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Young Soo Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Min-Ju Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Kee Don Choi
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Jeong Hoon Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Kwi-Sook Choi
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Do Hoon Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Hyun Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Ho June Song
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Gin Hyug Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
| | - Jin-Ho Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea
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Yamashita K, Takeno S, Nimura S, Sugiyama Y, Sueta T, Maki K, Kayashima Y, Shiwaku H, Kato D, Hashimoto T, Sasaki T, Yamashita Y. Gastric metastasis from salivary duct carcinoma mimicking primary gastric cancer. Int J Surg Case Rep 2016; 23:36-9. [PMID: 27085106 PMCID: PMC4855422 DOI: 10.1016/j.ijscr.2016.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 04/02/2016] [Accepted: 04/02/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION We present a very rare case of gastric metastasis mimicking primary gastric cancer in a patient who had undergone surgery for salivary duct carcinoma. PRESENTATION OF CASE A 67-year-old man had been diagnosed as having right parotid cancer and had undergone a right parotidectomy and lymph node dissection. The histological diagnosis was salivary duct carcinoma. One year after the surgery, a positron emission tomography-computed tomography scan using fluorodeoxyglucose (FDG) revealed an abnormal uptake of FDG in the left cervical, mediastinal, paraaortic, and cardiac lymph nodes; stomach; and pancreas. On gastroduodenoscopy, there was a huge, easily bleeding ulcer mimicking primary gastric cancer at the upper body of the stomach. Biopsy revealed poorly differentiated adenocarcinoma. Therefore, we were unable to differentiate between the primary gastric cancer and the metastatic tumor using gastroduodenoscopy and biopsy. Because of the uncontrollable bleeding from the gastric cancer, we performed an emergency palliative total gastrectomy. On histological examination, the gastric lesion was found to be metastatic carcinoma originating from the salivary duct carcinoma. DISCUSSION In the presented case, we could not diagnose the gastric metastasis originating from the salivary duct carcinoma even by endoscopic biopsy. This is because the histological appearance of salivary duct carcinoma is similar to that of high-grade adenocarcinoma, thus, resembling primary gastric cancer. CONCLUSION When we perform endoscopic examination of patients with malignant neoplasias, a possibility of metastatic gastric cancer should be taken into consideration.
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Affiliation(s)
- Kanefumi Yamashita
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
| | - Shinsuke Takeno
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Satoshi Nimura
- Department of Pathology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yoshikazu Sugiyama
- Department of Otolaryngology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Takayuki Sueta
- Department of Otolaryngology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Kenji Maki
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yoshiyuki Kayashima
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Hironari Shiwaku
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Daisuke Kato
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Tatsuya Hashimoto
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Takamitsu Sasaki
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yuichi Yamashita
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
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42
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Renal cell cancer metastases to esophagus and stomach successfully treated with radiotherapy and pazopanib. Anticancer Drugs 2016; 26:112-6. [PMID: 25075797 DOI: 10.1097/cad.0000000000000150] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Renal cell cancer has been rarely reported as a cause of gastric or esophageal metastases. They usually present with gastrointestinal bleeding and most cases have been managed surgically or endoscopically. We report the case of a 38-year-old man with a 4-year history of metastatic renal cell carcinoma admitted to the emergency room with melena and anemia. At endoscopy, three esophageal polypoid lesions (middle and distal thirds) and a 7 cm mass in the gastric fundus were identified. Biopsy revealed esophageal mucosa infiltrated by renal cell carcinoma. Radiotherapy was administered (30 Gy in 10 fractions), followed by pazopanib, with excellent tolerance and without new bleeding episodes. Computed tomography scan showed complete disappearance of the esophageal and fundic lesions at 3 months follow-up. Twenty-four months after being initiated on pazopanib, there is no radiological evidence of disease. This is the first reported case showing complete remission of gastric and esophageal metastases after treatment with radiotherapy and pazopanib.
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43
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Garg S, Mulki R, Sher D. Metastatic pancreatic cancer presenting as linitis plastica of the stomach. BMJ Case Rep 2016; 2016:bcr2015214298. [PMID: 26957034 PMCID: PMC4785451 DOI: 10.1136/bcr-2015-214298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2016] [Indexed: 12/20/2022] Open
Abstract
Metastatic disease from pancreatic carcinoma involving the stomach is an unusual event, and the pattern of spread in the form of linitis plastica, to our knowledge, has not been reported previously. Local recurrence after curative resection for pancreatic cancer is the most common pattern of disease. We report a case of metastatic pancreatic adenocarcinoma presenting as linitis plastica of the stomach 4 years after curative resection. A 52-year-old man presented with epigastric pain and melaena 4 years after undergoing a Whipple's procedure for a poorly-differentiated pancreatic adenocarcinoma, stage IB; T2N0M0. CT imaging of the abdomen revealed thickening of the gastric wall, and subsequent oesophagogastroduodenoscopy (OGD) revealed diffuse friable erythaematous tissue. The biopsy specimen obtained during the OGD revealed a poorly differentiated adenocarcinoma, with similar appearance to the prior specimen obtained from the pancreas.
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Affiliation(s)
- Shivani Garg
- Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
| | - Ramzi Mulki
- Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
| | - Daniel Sher
- Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA
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44
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Wu D, Wei S, Liu B, Wu X, Feng Y, Luo C, Ju Y, Liang J. Effect of immune suppression on metastasis in a patient with hepatocellular carcinoma metastasized to the colon and stomach: A case report. Exp Ther Med 2016. [PMID: 27168796 DOI: 10.3892/etm.2016.3108.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is a highly malignant cancer, which can invade the portal vein and cause liver/long bone metastasis, although digestive tract metastatic tumor from the liver is very rare. This case report describes an unusual case of HCC (clear cell type), determined by pathology of the original liver tumor resected on March 16th, 2004. The patient returned to our hospital in February and July 2009 complaining of 'black stool' in the first instance, and 'anemia' on the second occasion. Colonoscopy and gastroscopy indicated colon cancer and stomach cancer, respectively. The right half colon and distal stomach were resected, and pathological inspection revealed liver cancer metastasis. The patient succumbed to respiratory failure due to liver cancer lung metastasis on the May 23rd, 2013. Tests for CD4+ and CD8+ T cells and the CD4+/CD8+ ratio, in addition to the expression of Fas, Fas ligand (FasL), indicated an evident difference in patient immunity during the tumor metastasis period. The disease progression in this patient suggested that immune surveillance may have been involved in the metastases. Furthermore, this case shows that clinicians should be alert to the possibility of metastases in uncommon sites that may be misdiagnosed as primary tumors. Surgical resection remains a valuable treatment for isolated digestive tract metastasis from liver cancer.
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Affiliation(s)
- Dongde Wu
- Department of Hepatobiliary and Pancreatic Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Shaozhong Wei
- Department of Urology Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Baozhen Liu
- School Hospital of Wuhan Textile University, Wuhan, Hubei 430073, P.R. China
| | - Xinghong Wu
- Department of Breast Cancer Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Yaojun Feng
- Department of Breast Cancer Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Chenggang Luo
- Department of Hepatobiliary and Pancreatic Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Yiqing Ju
- Department of General Surgery, First Hospital of Wuxue County, Huanggang, Hubei 435400, P.R. China
| | - Jianjun Liang
- Department of General Surgery, First Hospital of Wuxue County, Huanggang, Hubei 435400, P.R. China
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45
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Wu D, Wei S, Liu B, Wu X, Feng Y, Luo C, Ju Y, Liang J. Effect of immune suppression on metastasis in a patient with hepatocellular carcinoma metastasized to the colon and stomach: A case report. Exp Ther Med 2016; 11:1741-1747. [PMID: 27168796 PMCID: PMC4840586 DOI: 10.3892/etm.2016.3108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/21/2016] [Indexed: 12/14/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is a highly malignant cancer, which can invade the portal vein and cause liver/long bone metastasis, although digestive tract metastatic tumor from the liver is very rare. This case report describes an unusual case of HCC (clear cell type), determined by pathology of the original liver tumor resected on March 16th, 2004. The patient returned to our hospital in February and July 2009 complaining of 'black stool' in the first instance, and 'anemia' on the second occasion. Colonoscopy and gastroscopy indicated colon cancer and stomach cancer, respectively. The right half colon and distal stomach were resected, and pathological inspection revealed liver cancer metastasis. The patient succumbed to respiratory failure due to liver cancer lung metastasis on the May 23rd, 2013. Tests for CD4+ and CD8+ T cells and the CD4+/CD8+ ratio, in addition to the expression of Fas, Fas ligand (FasL), indicated an evident difference in patient immunity during the tumor metastasis period. The disease progression in this patient suggested that immune surveillance may have been involved in the metastases. Furthermore, this case shows that clinicians should be alert to the possibility of metastases in uncommon sites that may be misdiagnosed as primary tumors. Surgical resection remains a valuable treatment for isolated digestive tract metastasis from liver cancer.
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Affiliation(s)
- Dongde Wu
- Department of Hepatobiliary and Pancreatic Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Shaozhong Wei
- Department of Urology Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Baozhen Liu
- School Hospital of Wuhan Textile University, Wuhan, Hubei 430073, P.R. China
| | - Xinghong Wu
- Department of Breast Cancer Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Yaojun Feng
- Department of Breast Cancer Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Chenggang Luo
- Department of Hepatobiliary and Pancreatic Surgery, Cancer Hospital of Wuhan University (Hubei Cancer Hospital), Wuhan, Hubei 430079, P.R. China
| | - Yiqing Ju
- Department of General Surgery, First Hospital of Wuxue County, Huanggang, Hubei 435400, P.R. China
| | - Jianjun Liang
- Department of General Surgery, First Hospital of Wuxue County, Huanggang, Hubei 435400, P.R. China
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46
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Sheybani A, Menias CO, Luna A, Fowler KJ, Hara AK, Silva AC, Yano M, Sandrasegaran K. MRI of the stomach: a pictorial review with a focus on oncological applications and gastric motility. ACTA ACUST UNITED AC 2015; 40:907-30. [PMID: 25261256 DOI: 10.1007/s00261-014-0251-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The purpose of this pictorial review is to demonstrate gastric pathology seen on magnetic resonance imaging (MRI) and discuss the essential MRI sequences for the evaluation of benign and malignant gastric pathologies. Common tumors of the stomach, polyposis syndromes, iatrogenic conditions, as well as other conditions of the stomach will be reviewed. The utility of MRI in the evaluation of patients with gastric malignancies and disorders of gastric motility will also be discussed.
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Affiliation(s)
- Arman Sheybani
- Department of Radiology, University of Illinois Hospital and Health Sciences System, University of Illinois at Chicago, 1740 W Taylor Street, Suite 2511, Chicago, IL, 60612, USA,
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47
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Dória MT, Maesaka JY, Martins SN, Silveira TP, Boufelli G, Siqueira SAC, Baracat EC, Filassi JR. Gastric metastasis as the first manifestation of an invasive lobular carcinoma of the breast. AUTOPSY AND CASE REPORTS 2015; 5:49-53. [PMID: 26558248 PMCID: PMC4636107 DOI: 10.4322/acr.2015.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/30/2015] [Indexed: 01/29/2023] Open
Abstract
Gastrointestinal metastases from breast cancer are rare and generally occur several years after the diagnosis of the primary lesion. The diagnosis of gastric metastasis as the initial presentation of breast cancer is even rarer and can potentially mimic gastric carcinoma. We report the case of a 66-year-old female patient submitted to a total gastrectomy because of the histological diagnosis of undifferentiated gastric carcinoma. During the surgical procedure, biopsies of the peritoneum and the liver were performed, which were consistent with metastatic breast invasive lobular carcinoma (ILC). The primary lesion of the breast was detected during the post-operative period, when a 4-cm-long lesion was detected on physical examination and mammography. The revision of the gastric biopsy confirmed the diagnosis of ILC. The authors call attention to the rarity of gastrointestinal metastases as the initial presentation of breast ILC.
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Affiliation(s)
- Maíra Teixeira Dória
- Department of Obstetrics and Gynecology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Jonathan Yugo Maesaka
- Department of Obstetrics and Gynecology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Sebastião Nunes Martins
- Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Thales Parenti Silveira
- Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | - Gabriela Boufelli
- Department of Obstetrics and Gynecology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | | | - Edmund Chada Baracat
- Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | - José Roberto Filassi
- Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
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48
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Ito T, Inokuma T. Gastric metastasis of pancreatic neuroendocrine tumor 5 years after surgical resection of the primary lesion. Dig Endosc 2015; 27:781. [PMID: 26257244 DOI: 10.1111/den.12531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 07/31/2015] [Accepted: 08/03/2015] [Indexed: 12/23/2022]
Affiliation(s)
- Takahiko Ito
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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49
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Yagi Y, Sasaki S, Yoshikawa A, Tsukioka Y, Fukushima W, Fujimura T, Hirosawa H, Izumi R, Saito K. Metastatic gastric carcinoma from breast cancer mimicking primary linitis plastica: A case report. Oncol Lett 2015; 10:3483-3487. [PMID: 26788154 PMCID: PMC4665745 DOI: 10.3892/ol.2015.3788] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 09/17/2015] [Indexed: 12/18/2022] Open
Abstract
Metastases to the gastrointestinal tract rarely occur in breast cancer except in invasive lobular carcinoma. The present study reports a rare case of metastatic gastric cancer from invasive ductal carcinoma (IDC) of the breast mimicking primary gastric linitis plastica. A 51-year-old premenopausal female, who had a history of partial mastectomy for right breast cancer at the age of 40, was referred to Toyama City Hospital (Toyoma, Japan) for an endoscopic diagnosis of gastric linitis plastica. Abdominal computed tomography (CT) revealed left hydronephrosis, while peritoneal metastasis and malignant ascites were not detected. Chest CT detected a left lung tumor, which had invaded the left upper bronchus. Biopsy specimens were obtained and the histopathological findings on both the gastric tumor and lung tumor demonstrated poorly differentiated adenocarcinoma, whereas the histology of the original breast cancer was IDC with a solid-tubular type. Immunohistochemistry revealed that the biopsied specimens of the gastric and lung tumors were positive for estrogen receptor (ER), progesterone receptor (PgR) and negative for human epithelial growth factor receptor-2 (HER2). These molecular characteristics indicated the case was metastatic gastric carcinoma from the breast cancer with lung metastasis, since the statuses of ER, PgR and HER2 were concordant with those of the original breast cancer. However, the possibility of primary gastric cancer could not be completely ruled out. Therefore, a total gastrectomy was performed for the purpose of both diagnosis and treatment. Pathological examination of the resected specimen provided a definite diagnosis of multiple metastatic gastric carcinomas from the breast. To the best of our knowledge, metastatic gastric cancer derived from the breast presenting as linitis plastica 11 years following the surgical removal of IDC has not been described previously.
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Affiliation(s)
- Yasumichi Yagi
- Department of Surgery, Toyama City Hospital, Toyama 939-8511, Japan
| | - Shozo Sasaki
- Department of Surgery, Toyama City Hospital, Toyama 939-8511, Japan
| | - Akemi Yoshikawa
- Department of Surgery, Toyama City Hospital, Toyama 939-8511, Japan
| | - Yuji Tsukioka
- Department of Surgery, Toyama City Hospital, Toyama 939-8511, Japan
| | - Wataru Fukushima
- Department of Surgery, Toyama City Hospital, Toyama 939-8511, Japan
| | - Takashi Fujimura
- Department of Surgery, Toyama City Hospital, Toyama 939-8511, Japan
| | - Hisashi Hirosawa
- Department of Surgery, Toyama City Hospital, Toyama 939-8511, Japan
| | - Ryohei Izumi
- Department of Surgery, Toyama City Hospital, Toyama 939-8511, Japan
| | - Katsuhiko Saito
- Department of Pathology, Toyama City Hospital, Toyama 939-8511, Japan
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50
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Prostate cancer metastasis to the stomach: 9 years after the initial diagnosis--case report and a literature review. J Gastrointest Cancer 2015; 45 Suppl 1:40-3. [PMID: 23949554 DOI: 10.1007/s12029-013-9527-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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