Case Report
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World J Gastrointest Oncol. Oct 15, 2010; 2(10): 395-398
Published online Oct 15, 2010. doi: 10.4251/wjgo.v2.i10.395
Gastric metastasis by primary lung adenocarcinoma
Ryota Okazaki, Hideyuki Ohtani, Kenichi Takeda, Takashi Sumikawa, Akira Yamasaki, Shingo Matsumoto, Eiji Shimizu
Ryota Okazaki, Kenichi Takeda, Takashi Sumikawa, Akira Yamasaki, Shingo Matsumoto, Eiji Shimizu, Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago-shi, Tottori-ken 683-8504, Japan
Hideyuki Ohtani, Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago-shi, Tottori-ken 683-8504, Japan
Author contributions: Okazaki R and Yamasaki A wrote the paper; Ohtani H, Takeda K, Sumikawa T, Watanabe M, Matsumoto S diagnosed and treated the patient; Shimizu E supervised in the editing the manuscript
Correspondence to: Ryota Okazaki, MD, Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago-shi, Tottori-ken 683-8504, Japan. okazaki@grape.med.tottori-u.ac.jp
Telephone: +81-859-386537 Fax: +81-859-386537
Received: December 16, 2009
Revised: August 20, 2010
Accepted: August 27, 2010
Published online: October 15, 2010
Abstract

The diagnosis of gastric metastasis from lung cancer is relatively rare in living patients. We describe a case of Type 4 tumor-like metastasis due to primary lung cancer diagnosed with immunohistochemical staining while the patient was alive. A 68-year-old man was admitted to our hospital because of epigastric pain. Gastrointestinal endoscopy revealed a Type 4 tumor and the histological examination showed poorly differentiated adenocarcinoma. His chest X-ray showed mass shadow in the right upper lung field. The resected specimens showed moderately differentiated adenocarcinoma., The diagnosis of gastric metastasis from lung cancer was made by immunohistochemical staining of the lung and gastric tumors which showed positive staining for Thyroid transcriptional factor-1. Diagnosis of gastric metastasis, especially Type 4 metastasis by lung cancer is difficult. However, immunohistochemical staining is very helpful for diagnosis of primary lung cancer metastasis at sites such as the gastrointestinal tract which are not normally prone to metastatis.

Keywords: Primary lung cancer, Type 4 gastric cancer, Gastric metastasis, Thyroid transcriptional factor-1