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1
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Shi RX, Guo ZP, Li X, Wang H, Wang B, Du MY, Wang JJ, Dong ZY. Small intestine metastasis from lung adenocarcinoma: A case report and review of literature. World J Gastrointest Surg 2025; 17:104049. [DOI: 10.4240/wjgs.v17.i5.104049] [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: 12/10/2024] [Revised: 03/03/2025] [Accepted: 04/09/2025] [Indexed: 05/23/2025] Open
Abstract
BACKGROUND The clinical metastasis rate of lung cancer is tremendously low in gastrointestinal tract. Individuals enduring small intestine metastasis of lung cancer are normally featured by less desirable prognosis and shorter survival than those with metastasis in other parts of the body. As a consequence, it holds crucial significance to conduct early diagnosis and development of systematic treatment for patients with gastrointestinal metastasis in lung cancer.
CASE SUMMARY In this case, a 59-year-old female patient, diagnosed with lung adenocarcinoma, experienced intestinal obstruction attributable to subsequent small intestinal metastasis. Imaging confirmed the metastasis to the small intestine after the adenocarcinoma diagnosis, ultimately giving rise to advanced-stage intestinal obstruction. Conservative treatment proved ineffective, progressing to intestinal perforation in the later stages. This resulted in peritonitis and infectious toxic shock and other serious clinical manifestations. Aggressive surgical resection mitigated the risk of disease progression and even fatality, which tremendously ameliorated the patient’s prognosis and prolonged her survival.
CONCLUSION Patients enduring lung cancer who exhibit acute abdominal symptoms should be mindful of the potential for small intestinal metastasis. Intestinal perforation typically occurs in advanced stages of the disease. Moreover, and aggressive surgical treatment can mitigate the risk of multifarious complications such as peritonitis, infectious toxic shock, and even fatality.
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Affiliation(s)
- Rui-Xian Shi
- Department of Neurology, Baotou Central Hospital, Baotou 014040, Inner Mongolia Autonomous Region, China
- Department of Neurology, Inner Mongolia Medical University, Hohhot 010080, Inner Mongolia Autonomous Region, China
| | - Zhen-Ping Guo
- Department of Cardiothoracic and Vascular Surgery, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Xin Li
- Department of Cardiothoracic and Vascular Surgery, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Hui Wang
- Department of Cardiothoracic and Vascular Surgery, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Bo Wang
- Department of Cardiothoracic and Vascular Surgery, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
| | - Ming-Yue Du
- Department of General Surgery, Baotou Central Hospital, Baotou 014040, Inner Mongolia Autonomous Region, China
| | - Ji-Jun Wang
- Department of General Surgery, Baotou Central Hospital, Baotou 014040, Inner Mongolia Autonomous Region, China
| | - Zhen-Yu Dong
- Department of Cardiothoracic and Vascular Surgery, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China
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2
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Hasan F, Timsaal Y, Gandhi T, Shojaei H, Schwartz M, Chaaya A. Rare Gastric Metastasis From Cervical Cancer: A Case Report. Clin Case Rep 2025; 13:e70181. [PMID: 39917371 PMCID: PMC11798869 DOI: 10.1002/ccr3.70181] [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: 10/25/2024] [Revised: 01/20/2025] [Accepted: 01/28/2025] [Indexed: 02/09/2025] Open
Abstract
MGTs most commonly arise from malignant melanoma. MGTs from primary cervical cancers are an extremely rare clinical finding with only a limited number of cases reported in the literature to date. We present the case of a 41-year-old female who presented with complaints of dysphagia and fatigue with a history of advanced cervical cancer. Endoscopy results revealed an infiltrating metastatic mass, with biopsy findings consistent with squamous gastric carcinoma of metastatic origin. Despite being on parenteral nutrition, poor disease prognosis led to eventually being discharged to hospice.
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Affiliation(s)
- Fariha Hasan
- Department of Internal MedicineCooper University HospitalCamdenNew JerseyUSA
| | | | | | - Hadi Shojaei
- Department of PathologyCooper University HospitalCamdenNew JerseyUSA
| | - Michael Schwartz
- Department of GastroenterologyCooper University HospitalCamdenNew JerseyUSA
| | - Adib Chaaya
- Cooper Medical School of Rowan UniversityCamdenNew JerseyUSA
- Department of GastroenterologyCooper University HospitalCamdenNew JerseyUSA
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3
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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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4
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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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5
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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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6
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Lundeberg K, Wolford J, Reid T. Gastric mucosa as a rare recurrence location of endometrial endometrioid adenocarcinoma. Gynecol Oncol Rep 2024; 53:101390. [PMID: 38623268 PMCID: PMC11016855 DOI: 10.1016/j.gore.2024.101390] [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: 03/14/2024] [Revised: 03/31/2024] [Accepted: 04/06/2024] [Indexed: 04/17/2024] Open
Abstract
Endometrial cancer is the most common gynecologic malignancy in the United States, with a prevalence of 25.7 per 100,000 women per year (Mahdy et al., 2023). Recurrences of endometrial carcinoma have a mean interval of occurring 2-3 years after primary treatment, with 64 % of cases occurring within 2 years and 87 % by the third year (Kurra et al., 2013). The most common sites of recurrence include the pelvis, pelvic and para-aortic lymph nodes, peritoneum, and the lungs (Kurra et al., 2013). Here, we describe a 72-year-old female with recurrent Stage IIIA endometrial adenocarcinoma in the gastric mucosa, an unusual location for recurrence of this type of cancer.
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Affiliation(s)
- Kathleen Lundeberg
- Department of Obstetrics and Gynecology, Wright-Patterson Medical Center, United States
- Wright State University, Boonshoft School of Medicine Obstetrics and Gynecology Residency, United States
| | - Juliet Wolford
- University of Cincinnati, Division of Gynecologic Oncology, United States
| | - Thomas Reid
- University of Cincinnati, Division of Gynecologic Oncology, United States
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7
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Vural Topuz O, Bağbudar S. Cervical Cancer Metastasis to the Stomach Masquerading as Primary Gastric Cancer: A Case Report of a Rare Metastasis Detected via 18F-FDG PET/CT. Nuklearmedizin 2024; 63:221-223. [PMID: 38190994 DOI: 10.1055/a-2224-9673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Affiliation(s)
- Ozge Vural Topuz
- Department of Nuclear Medicine, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Sidar Bağbudar
- Department of Pathology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
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8
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Tjahja M, Tran PP, Binsol PD, Ramirez JC. A Case of Breast Cancer Metastasizing to the Ampulla of Vater. Cureus 2024; 16:e58396. [PMID: 38756323 PMCID: PMC11097995 DOI: 10.7759/cureus.58396] [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: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Secondary tumors of the ampulla of Vater are exceedingly rare and associated with relatively poor prognosis. Tumors of the ampulla are classified into four distinct subtypes based on the location and involvement of surrounding structures. Most reported cases are of renal cell or malignant skin melanoma primary with only five previously reported cases of breast primary found in a literature review. We present a 72-year-old woman with metastatic breast cancer to the ampulla of Vater as well as multiple bones. She had a history of breast cancer status post bilateral mastectomy and chemo 27 years prior. She presented to the hospital with altered mental status and was found to have an acute liver injury. Magnetic resonance cholangiopancreatography revealed a distended gallbladder and an indeterminate left retroperitoneal mass concerning for cystic or necrotic lymphadenopathy. Endoscopy then showed an edematous and erythematous periampullary region, which was biopsied and returned positive for carcinoma. Immunohistochemical staining of the retroperitoneal mass returned positive for keratin, estrogen receptor, GATA3, and MOC31 and negative for progesterone receptor, WT1, calretinin, and E-cadherin. The periampullary region's immunohistochemistry returned positive for pankeratin (AE1/AE3) and CD138 and negative for CD45 and S100, supporting a diagnosis of primary breast carcinoma. The average time from diagnosis of breast cancer to metastasis was found to be 2.5 years. Endoscopic visual presentation of metastatic cancer to the ampulla is indistinguishable from that of primary cancers. Thus, a biopsy with cytology and immunohistochemical analysis is necessary for diagnosis. Management of secondary ampullary tumors requires a multidisciplinary team, including gastroenterology, surgery, oncology, and often palliative care. Secondary tumors have been found to be treated by any combination of Whipple's resections, chemotherapy, drainage/stenting, and endoscopic ampullectomy.
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Affiliation(s)
- Matthew Tjahja
- Internal Medicine, Baylor Scott and White Temple Medical Center, Temple, USA
| | - Phi P Tran
- Internal Medicine, Baylor Scott and White Temple Medical Center, Temple, USA
| | | | - Jonathan C Ramirez
- Gastroenterology, Baylor Scott and White Temple Medical Center, Temple, USA
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9
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Xu L, Wang C, Yang X, Dong L. Case report: Cutaneous metastases as a first manifestation from breast cancer with concurrent gastric metastases. Front Pharmacol 2024; 15:1356167. [PMID: 38500767 PMCID: PMC10945424 DOI: 10.3389/fphar.2024.1356167] [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: 12/15/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024] Open
Abstract
Background: Breast cancer represents a leading cause of malignancy among Chinese women, posing a significant health burden. The diagnosis of metastatic breast cancer, particularly to uncommon sites like the skin and stomach, presents distinct challenges. Case introduction: This case report describes a 71-year-old Chinese women with a persistent back rash lasting more than 6 months. Physical examination revealed red papules on her back. Immunohistochemistry confirmed positive for cytokeratin 7(CK7), GATA-3 and GCDFP15, as well as negative staining of cytokeratin 20 (CK20), suggesting breast cancer metastasis. Further evaluation revealed a breast nodule and axillary lymph node enlargement, with biopsies confirming invasive lobular carcinoma (ILC). Abdominal computed tomography (CT) revealed thickening of the gastric and ascending colon walls. Gastroscopy revealed chronic superficial atrophic gastritis. However, gastric metastasis was further confirmed by pathology. The patient initiated endocrine therapy with fulvestrant and exemestane, resulting in rash resolution and stable breast and stomach lesions after 3 months. Overall, the patient is experiencing an improvement in her condition and remains stable while continuing treatment. Conclusion: This case highlights the importance of considering atypical metastatic patterns in breast cancer and the potential efficacy of endocrine therapies in managing such cases. Moreover, it emphasizes the need for vigilance in breast cancer patients, especially those with ILC, as gastrointestinal symptoms may indicate gastric metastasis (GMs). Ultimately, early detection and appropriate treatment strategies, such as endocrine therapy, can contribute to improved outcomes in these challenging cases.
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Affiliation(s)
- Lulu Xu
- Departments of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Congcong Wang
- Departments of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Xiaoling Yang
- Department of Obstetrics, Feicheng People’s Hospital, Feicheng, China
| | - Liangliang Dong
- Departments of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
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10
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Kishimoto K, Shibagaki K, Araki A, Murakami K, Takahashi Y, Kotani S, Oka A, Yazaki T, Fukuba N, Mishima Y, Oshima N, Kawashima K, Ishimura N, Kadota K, Ishihara S. Gastric Metastasis from Salivary Duct Carcinoma Mimicking Scirrhous Gastric Cancer. Intern Med 2024; 63:373-378. [PMID: 37344429 PMCID: PMC10901704 DOI: 10.2169/internalmedicine.1965-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 04/27/2023] [Indexed: 06/23/2023] Open
Abstract
A 59-year-old man underwent submandibular gland excision for salivary duct carcinoma (SDC). One year later, esophagogastroduodenoscopy indicated gastric diffuse mucosal thickening with luminal contraction, mimicking scirrhous gastric carcinoma. Biopsy specimens showed dense proliferation of neoplastic cells expressing androgen receptor and human epidermal growth factor 2, indicating SDC. Gastric diffuse infiltrative metastasis is generally characteristic of gastric metastasis from invasive ductal carcinoma, which shows histologic features similar to SDC. This is the first known report of gastric diffusely infiltrating metastasis in an SDC patient. Rapidly progressing, diffuse gastric wall thickening should also be considered indicative of salivary tumor-associated gastric metastasis.
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Affiliation(s)
- Kenichi Kishimoto
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | | | - Asuka Araki
- Department of Pathology, Faculty of Medicine, Shimane University, Japan
| | - Kotaro Murakami
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Yusuke Takahashi
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Satoshi Kotani
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Akihiko Oka
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Tomotaka Yazaki
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Nobuhiko Fukuba
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Yoshiyuki Mishima
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Naoki Oshima
- Department of Endoscopy, Shimane University Hospital, Japan
| | - Kousaku Kawashima
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Norihisa Ishimura
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Kyuichi Kadota
- Department of Pathology, Faculty of Medicine, Shimane University, Japan
| | - Shunji Ishihara
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
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11
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Tom CK, Placone N, Yung E, Shaker A. The Travels of Signet-Ring Cell Carcinoma: From Colon to Stomach and Duodenum. ACG Case Rep J 2023; 10:e01239. [PMID: 38130481 PMCID: PMC10735161 DOI: 10.14309/crj.0000000000001239] [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: 08/09/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
Colorectal cancer (CRC) metastasizing to the stomach and duodenum is rare. Even rarer is when the CRC subtype is signet-ring cell carcinoma (SRCC). Endoscopic findings of CRC metastasis to the stomach have been described as solitary and submucosal while duodenal metastasis has been observed to be exophytic. In this report, we describe a case of a middle-aged man with colon SRCC presenting with oral intolerance. He was found to have concurrent metastases to the stomach and duodenum and died 8 months after his SRCC diagnosis.
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Affiliation(s)
- Chloe K. Tom
- Division of Gastrointestinal and Liver Diseases, University of Southern California, Los Angeles, CA
| | - Nicholas Placone
- Division of Gastrointestinal and Liver Diseases, University of Southern California, Los Angeles, CA
| | - Evan Yung
- Department of Pathology, University of Southern California, Los Angeles, CA
| | - Anisa Shaker
- Division of Gastrointestinal and Liver Diseases and Swallowing and Esophageal Disorders Center, University of Southern California, Los Angeles, CA
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12
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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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13
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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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14
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Silva MA, Leal C, Ruge A, Fernandes A, Cunha MF, Vasconcelos H. Testicular Seminoma Presenting as Gastrointestinal Bleeding: A Rare Cause of Metastatic Disease in the Stomach. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2023; 30:311-315. [PMID: 37767307 PMCID: PMC10521319 DOI: 10.1159/000526427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/18/2022] [Indexed: 09/29/2023]
Abstract
Introduction Gastric metastases are quite infrequent. When arising from testicular germ cell tumors, gastric metastases are usually associated with nonseminomas. Case Report A 45-year-old man presented with upper gastrointestinal bleeding, severe anemia, and elevated lactate dehydrogenase. Endoscopy revealed three atypical-looking gastric ulcers. Abdominal computed tomography showed an extensive heterogeneous retroperitoneal mass and a smaller one in the pelvis. Biopsies of both the ulcers and the retroperitoneal mass revealed a highly proliferative neoplasia of unknown origin. While the diagnostic work up was taking place, the patient complained of a testicular mass which was resected, after suspicious findings in the ultrasound. Histopathologic findings revealed a testicular seminoma. Revision of previous biopsies was compatible with metastatic seminoma to the stomach and the retroperitoneum. Discussion/Conclusion Gastric metastasis arising from testicular seminoma is quite infrequent and usually diagnosed after the primary tumor is known. We report a rare case of a testicular seminoma presenting as upper gastrointestinal bleeding due to gastric metastases. This case highlights the importance of detailed anamnesis and physical examination in the differential diagnosis of atypical gastric ulcers with initial inconclusive work up and emphasizes an unusual manifestation of a germ cell malignancy.
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Affiliation(s)
- Maria Azevedo Silva
- Department of Gastroenterology, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Carina Leal
- Department of Gastroenterology, Centro Hospitalar de Leiria, Leiria, Portugal
| | - André Ruge
- Department of Gastroenterology, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Alexandra Fernandes
- Department of Gastroenterology, Centro Hospitalar de Leiria, Leiria, Portugal
| | | | - Helena Vasconcelos
- Department of Gastroenterology, Centro Hospitalar de Leiria, Leiria, Portugal
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15
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Trpchevska EN, Todorovska B, Todorovska MB, Trajkovska M, Nikolova D, Dzambaz D, Deriban G, Licoska-Josifovikj F. Testicular Mixed Germ Cell Tumor Presenting with Upper Gastrointestinal Bleeding: A Case Report. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2023; 44:47-52. [PMID: 37453124 DOI: 10.2478/prilozi-2023-0024] [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] [Indexed: 07/18/2023]
Abstract
Testicular mixed germ cell tumors (TMGCTs) are aggressive neoplasms that often have metastases at the time of diagnosis, primarily in the lungs, bones, and brain. Gastrointestinal metastases are rare, occurring in less than 5% of cases, while duodenal involvement is extremely rare, with only few reported cases. Furthermore, gastrointestinal bleeding is an atypical initial presentation of metastatic TMGCTs. Herein, we present a very rare case of upper gastrointestinal bleeding caused by a duodenal metastasis of a TMGCT in a 24-year-old man. The patient was admitted to our hospital due to abdominal pain and melena with a hemoglobin level of 52 g/L. He had no history of testicular swelling, or any other symptoms or signs of a testicular tumor. Upper gastrointestinal endoscopy revealed a duodenal tumor mass with irregular bleeding, and abdominal ultrasound and computed tomography showed a duodenal mass that infiltrate retroperitoneum. Emergency surgery was performed, and the histopathological findings of the resected specimen were consistent with TMGCT metastasis. Subsequently, a testicular tumor was confirmed and surgically removed; however, multiple metastatic deposits were observed in the lungs. Due to the patient's poor general condition, chemotherapy was not performed. The patient died 3 months after the initial diagnosis. This case suggests that, although duodenal metastatic TMGCTs are rare, they should be considered in the differential diagnosis of gastrointestinal bleeding in young male patients.
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Affiliation(s)
- Emilija Nikolovska Trpchevska
- 1University Clinic of Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, RN Macedonia
| | - Beti Todorovska
- 1University Clinic of Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, RN Macedonia
| | | | - Meri Trajkovska
- 1University Clinic of Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, RN Macedonia
| | - Dafina Nikolova
- 1University Clinic of Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, RN Macedonia
| | - Darko Dzambaz
- 3University Clinic of Digestive Surgery, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, RN Macedonia
| | - Gjorgji Deriban
- 1University Clinic of Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, RN Macedonia
| | - Fana Licoska-Josifovikj
- 1University Clinic of Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, RN Macedonia
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16
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Wang M, Zhang W, Fu C, Guan J, Ni X, Yao F. Endoscopic manifestations and treatment outcomes of asymptomatic gastric metastases from primary lung adenocarcinoma: Report of two cases. Oncol Lett 2023; 25:228. [PMID: 37153059 PMCID: PMC10157602 DOI: 10.3892/ol.2023.13814] [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: 11/02/2022] [Accepted: 03/16/2023] [Indexed: 05/09/2023] Open
Abstract
Metastatic spread of lung adenocarcinoma to the stomach is rare and most gastric metastases are discovered at the advanced stage due to certain symptoms. The present study reported two cases of asymptomatic gastric metastases from lung adenocarcinoma presenting as diminutive nodules or erosion endoscopically. The manifestations were also visualized under magnifying endoscopy with blue laser imaging (BLI-ME), the two cases share certain common characteristics under BLI-ME, such as an obviously widened intervening part and extended subepithelial capillary network, which indicated that lesions developed beneath the superficial epithelium. Target biopsy and further immunohistochemical staining confirmed that the gastric lesions were metastatic from primary lung cancer. None of the two patients were candidates for surgery due to multiple distant metastases, but the gastric metastases regressed to scars after systemic anticancer therapy. These two cases were presented in order to improve the current understanding of the endoscopic manifestations of early gastric metastases from lung cancer, and the outcomes may demonstrate that systemic treatment is effective for eliminating early gastric metastatic lesions.
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Affiliation(s)
- Meiling Wang
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P.R. China
| | - Wei Zhang
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P.R. China
| | - Chunmei Fu
- Department of Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P.R. China
| | - Jian Guan
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P.R. China
| | - Xiaoguang Ni
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, P.R. China
- Correspondence to: Professor Fang Yao and Professor Xiaoguang Ni, Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 117 Panjiayuan Nanli, Chaoyang, Beijing 100020, P.R. China, E-mail:
| | - Fang Yao
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, P.R. China
- Correspondence to: Professor Fang Yao and Professor Xiaoguang Ni, Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 117 Panjiayuan Nanli, Chaoyang, Beijing 100020, P.R. China, E-mail:
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17
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Jinushi R, Tashima T, Sato R, Kawasaki T, Ryozawa S. Invasive lobular carcinoma metastasis mimicking primary gastric signet ring cell carcinoma. Clin Case Rep 2023; 11:e6953. [PMID: 36846175 PMCID: PMC9944045 DOI: 10.1002/ccr3.6953] [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: 09/24/2022] [Revised: 12/15/2022] [Accepted: 01/27/2023] [Indexed: 02/24/2023] Open
Abstract
The endoscopic findings of gastric metastases from breast carcinoma are nonspecific, and often difficult to distinguish from primary gastric signet ring cell carcinoma. Therefore, pathological findings are key to diagnosis.
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Affiliation(s)
- Ryuhei Jinushi
- Department of GastroenterologySaitama Medical University International Medical CenterSaitamaJapan
- Department of Gastroenterology Medicine CenterShonan Kamakura General HospitalKamakuraJapan
| | - Tomoaki Tashima
- Department of GastroenterologySaitama Medical University International Medical CenterSaitamaJapan
| | - Ryo Sato
- Department of GastroenterologySaitama Medical University International Medical CenterSaitamaJapan
| | - Tomonori Kawasaki
- Department of PathologySaitama Medical University International Medical CenterSaitamaJapan
| | - Shomei Ryozawa
- Department of GastroenterologySaitama Medical University International Medical CenterSaitamaJapan
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18
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Yang B, Gan Z, Liu S, Si G. Synchronous isolated gastric metastases from ascending colon carcinoma: A case report. Medicine (Baltimore) 2022; 101:e32476. [PMID: 36595810 PMCID: PMC9794282 DOI: 10.1097/md.0000000000032476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Gastric metastases (GMs) are rare and often accompanied with synchronous metastases of other organs. Synchronous isolated GMs from ascending colon carcinoma are uncommon and rarely studied. GMs may be confused with primary gastric tumors. METHODS A 45-year-old man presented to our hospital with abdominal distensionand anal pendant expansion. The abdominal physical examination was negative. The positive fecal occult blood test and the negative tumor marker were obtained. Colonoscopy and gastroduodenoscopy revealed a polypoidal lesion in the ascending colon and a polypoid mass in the gastric body, respectively. CT showed the thickened wall of ascending colon and polypoid mass in the gastric body with homogenous enhancement. Additionally, synchronous gastric metastases from the ascending colon carcinoma were confirmed by pathology after laparoscopic right hemicolectomy and partial gastrectomy. After 13 individual doses of fluorouracil (2.8 g/time), calcium leucovorin (0.8 g/time), and oxaliplatin (85 mg/time), the patient was discharged without any discomfort, without any additional metastases detected during the following 18 months.1. RESULTS A rare case of synchronous isolated gastric metastasis from ascending colon carcinoma was confirmed by computed tomography (CT) and pathological diagnosis. CONCLUSION GM may appear as a polypoid lesion. Surgery combined with chemotherapy may improve the prognosis in patients with synchronous isolated GM.
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Affiliation(s)
- Bin Yang
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China
- * Correspondence: Bin Yang, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China (e-mail: )
| | - Zhonghua Gan
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China
| | - Shulan Liu
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China
| | - Guangyan Si
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, 182 chunhui RD, Lu Zhou, Sichuan, People’s Republic of China
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19
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Li T, Jiang X, Zhang Z, Chen X, Wang J, Zhao X, Zhang J. Case Report: 68Ga-FAPI PET/CT, a more advantageous detection mean of gastric, peritoneal, and ovarian metastases from breast cancer. Front Oncol 2022; 12:1013066. [PMID: 36387126 PMCID: PMC9643837 DOI: 10.3389/fonc.2022.1013066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 10/11/2022] [Indexed: 12/02/2022] Open
Abstract
Breast cancer is the most common malignant tumor in adult women. Its common metastatic sites are lymph nodes, bones, lungs, the liver, and the brain. It is so rare for a patient with breast cancer to have metastases of the gastrointestinal tract, peritoneum, and ovary at the same time that the clinical reporting rate is low. We present a case of a 61-year-old woman who underwent right mastectomy and chemoradiotherapy 3 years ago because of mixed invasive ductal-lobular breast cancer. This time, she came to the hospital due to the symptom of stomach discomfort for 2 weeks. The gastroscopy biopsy result showed gastric metastasis from breast cancer. Then, 18F-FDG imaging and 68Ga-FAPI PET/CT imaging were performed for further diagnosis; 68Ga-FAPI PET/CT demonstrated a significantly elevated FAPI activity in the thickened gastric wall, peritoneum, and bilateral adnexal areas, which was superior to that of 18F-FDG. Finally, a biopsy of suspicious lesions was taken for pathological and histochemical examination, which confirmed that, in addition to the gastric metastasis, the peritoneum and bilateral ovaries were all consistent with metastatic breast cancer.
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Affiliation(s)
- Tianyue Li
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China
| | - Xiaojing Jiang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhaoqi Zhang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaolin Chen
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jianfang Wang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xinming Zhao
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China
- *Correspondence: Jingmian Zhang, ; Xinming Zhao,
| | - Jingmian Zhang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China
- *Correspondence: Jingmian Zhang, ; Xinming Zhao,
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20
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A case of gastric metastasis originating from right-sided colon cancer 4 years after colectomy. Future Sci OA 2022; 8:FSO818. [DOI: 10.2144/fsoa-2022-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
The stomach is rarely a metastatic site of other primary cancers. Gastric metastasis from colonic cancer is exceptional. We hereby report a case of a 54-year-old male patient who underwent a right hemicolectomy for right-sided colon cancer. The pathology exam revealed well differentiated adenocarcinoma, it was classified stage IIb. Regular controls performed including colonoscopy were normal. Four years after colectomy, the patient was admitted for hematemesis with epigastric pain with detoriation of general condition . Gastroscopy revealed a large ulceroproliferative mass in the antropyloric region. Histology showed that this tumor was an adenocarcinoma similar to the primary right colon cancer, which led to the diagnosis of metastatic gastric cancer originating from colon cancer.
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21
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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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22
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Sekaran A, Dey D, Singh A, Das P. Pathology of Malignant Lesions of the Gastrointestinal Tract. SURGICAL PATHOLOGY OF THE GASTROINTESTINAL SYSTEM 2022:699-782. [DOI: 10.1007/978-981-16-6395-6_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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23
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Kim JH, Kang CD, Lee K, Lim KH. Metachronous squamous cell carcinoma of pancreas and stomach in an elderly female patient: A case report. World J Clin Cases 2021; 9:9680-9685. [PMID: 34877306 PMCID: PMC8610886 DOI: 10.12998/wjcc.v9.i31.9680] [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: 07/13/2021] [Revised: 08/25/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Squamous cell carcinoma (SCC) in pancreas and stomach is a rare histologic subtype with aggressive behavior, poor prognosis, and no standardized therapy. Pancreatic SCC or gastric SCC has been previously reported. However, case of SCC occurring in both the pancreas and the stomach has not been reported yet.
CASE SUMMARY A 75-year-old female with prior history of hypertension and diabetes mellitus visited our hospital with complaint of abdominal pain that started three months ago. Computed tomography (CT) scan of the abdomen showed 3.3 cm mass at the distal pancreas. She received surgical resection which was histologically found to be SCC of the pancreas with clear resection margins. After she was discharged, she no longer visited the hospital. Three years later, she was referred to our hospital after showing abnormal findings on a gastroscopy performed at another hospital. Gastroscopy revealed a single, 2cm sized, ill-defined irregular flat and hyperemic mass at high body. Histologic finding of the mass was SCC. CT scan and positive emission tomography CT showed metastatic lesions to the liver and the peritoneum. She received combination chemotherapy with capecitabine and oxaliplatin. However, she passed away 6 mo after diagnosis of gastric SCC.
CONCLUSION To the best of our knowledge, this is the first case of metachronous SCC of stomach occurring after diagnosis of pancreatic SCC.
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Affiliation(s)
- Ji Hyun Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24341, Kangwon Do, South Korea
| | - Chang Don Kang
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24341, Kangwon Do, South Korea
| | - Kyungyul Lee
- Department of Pathology, Kangwon National University School of Medicine, Chuncheon 24341, Kangwon Do, South Korea
| | - Kyu-Hyoung Lim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24341, Kangwon Do, South Korea
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24
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Hakim C, Mendelson A, Patel J, Greer J, Sorser S. Metastatic Renal Cell Carcinoma Presenting as Gastrointestinal Bleeding. Case Rep Gastroenterol 2021; 15:478-481. [PMID: 34616243 PMCID: PMC8454225 DOI: 10.1159/000514376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/12/2021] [Indexed: 12/11/2022] Open
Abstract
Approximately 85% of kidney tumors are renal cell carcinoma (RCC). RCC commonly metastasizes to the lung, bone, and lymph nodes; however, gastric metastasis is exceedingly rare. We present an 86-year-old woman with left-sided RCC with known metastatic disease to the lungs, lymph nodes, and bone, who presented with acute blood loss anemia. After hemodynamic stabilization, esophagogastroduodenoscopy revealed a large infiltrative, polypoid, and ulcerated polyp in the gastric body. After complete polypectomy, histological examination demonstrated gastric mucosa ulcerated by clear-cell carcinoma, compatible with metastatic RCC. Our patient was successfully treated with palliative radiation to the gastric body.
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Affiliation(s)
- Christopher Hakim
- Department of Internal Medicine, Ascension Providence Hospital - Michigan State University College of Human Medicine, Southfield, Michigan, USA
| | - Avery Mendelson
- Department of Internal Medicine, Ascension Providence Hospital - Michigan State University College of Human Medicine, Southfield, Michigan, USA
| | - Jalpa Patel
- Department of Gastroenterology, Ascension Providence Hospital - Michigan State University College of Human Medicine, Southfield, Michigan, USA
| | - Julia Greer
- Department of Gastroenterology, Ascension Providence Hospital - Michigan State University College of Human Medicine, Southfield, Michigan, USA
| | - Serge Sorser
- Department of Gastroenterology, Ascension Providence Hospital - Michigan State University College of Human Medicine, Southfield, Michigan, USA
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25
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Maelle R, Jean-Philippe R, Jochen W, Geraldine P, Fabrice C, Christian P, Mathilde G, Slimane D, Serge B, Naji S, Cecile V, Stanislas R, Thomas M, Sami F, Manuel T, Marc G, Gwenaelle G. Gastrointestinal Metastases From Primary Renal Cell Cancer: A Single Center Review. Front Oncol 2021; 11:644301. [PMID: 33833995 PMCID: PMC8023271 DOI: 10.3389/fonc.2021.644301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction: Digestive metastases (DMs) from renal cell cancer (RCC) are rare. Over the past decade, the overall survival of metastatic RCC (mRCC) has been improved by tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors. The main objective of this study was to assess the incidence of metastases of the digestive tract in this new field of treatment. The secondary objectives were to evaluate the clinical characteristics, prognosis, treatments used for DMs, and median time between the diagnosis of RCC or mRCC and DMs. Materials and Methods: A retrospective analysis of data collected from all patients with mRCC between 2007 (the time of TKI was a standard of care) and 2019 was carried out at the Paoli-Calmettes Institute (Marseille, France). Computer research software using artificial intelligence (ConSoRe®) was used to identify patients and assess their characteristics. Results: Between January 2007 and December 2019, 11 out of 660 (1.6%) mRCC patients had metastases of the gastrointestinal tract. The median age was 62 years. Of the 11 patients, 81.8% experienced digestive bleeding or anemia. Only 2 patients were asymptomatic. The metastases were mainly duodenal (50%) and gastric (41.6%). The median time from cancer diagnosis and from metastatic disease to gastrointestinal metastasis was 4.3 years (3 months-19.2 years) and 2.25 years (0 days-10.2 years), respectively. Local treatment was performed in 38.5% of cases by endoscopy (60%), surgery (20%) and radiotherapy (40%) with success rates of 33, 100, and 50%, respectively. Etiological treatment was modified following the discovery of DM in 84.6% of the cases. The median survival was 1 year from the diagnosis of DM (13 days-9.4 years). Two patients were still alive 2.9 and 9.4 years after the diagnosis of DM. Conclusion: This is the largest monocentric retrospective analysis of DM in patients with RCC. It seems to be a rare and late event in the course of the disease. Local treatment combined with systemic treatment could improve survival. In the context of prolonged survival with the new based immunotherapy treatments in mRCC, we suggest that unexplained anemia or persistent digestive symptoms could be explored by endoscopy.
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Affiliation(s)
- Rony Maelle
- Paoli-Calmettes Institute, Department of Gastrointestinal Disease, Marseille, France
| | - Ratone Jean-Philippe
- Paoli-Calmettes Institute, Department of Gastrointestinal Disease, Marseille, France
| | - Walz Jochen
- Paoli-Calmettes Institute, Department of Urology, Marseille, France
| | - Pignot Geraldine
- Paoli-Calmettes Institute, Department of Urology, Marseille, France
| | - Caillol Fabrice
- Paoli-Calmettes Institute, Department of Gastrointestinal Disease, Marseille, France
| | - Pesenti Christian
- Paoli-Calmettes Institute, Department of Gastrointestinal Disease, Marseille, France
| | - Guerin Mathilde
- Paoli-Calmettes Institute, Department of Medical Oncology, Marseille, France
| | - Dermeche Slimane
- Paoli-Calmettes Institute, Department of Medical Oncology, Marseille, France
| | - Brunelle Serge
- Paoli-Calmettes Institute, Department of Radiology, Marseille, France
| | - Salem Naji
- Paoli-Calmettes Institute, Department of Radiotherapy, Marseille, France
| | - Vicier Cecile
- Paoli-Calmettes Institute, Department of Medical Oncology, Marseille, France
| | | | - Maubon Thomas
- Paoli-Calmettes Institute, Department of Urology, Marseille, France
| | - Fakhfakh Sami
- Paoli-Calmettes Institute, Department of Urology, Marseille, France
| | - Tejeda Manuel
- Paoli-Calmettes Institute, Department of Informatics, Marseille, France
| | - Giovannini Marc
- Paoli-Calmettes Institute, Department of Gastrointestinal Disease, Marseille, France
| | - Gravis Gwenaelle
- Paoli-Calmettes Institute, Department of Medical Oncology, Aix-Marseille University, Inserm, CNRS, CRCM, Marseille, France
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26
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Malignant Melanoma of the Gastrointestinal Tract: Symptoms, Diagnosis, and Current Treatment Options. Cells 2021; 10:cells10020327. [PMID: 33562484 PMCID: PMC7915313 DOI: 10.3390/cells10020327] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/21/2022] Open
Abstract
Malignant melanoma (MM) has become the fifth most frequent cancer in the UK. It is the most common carcinoma to metastasize to the gastrointestinal (GI) tract. MM particularly has an affinity to spread to the small bowel, which is followed by the involvement of the stomach and large intestine. Excellent endoscopic options including video capsule endoscopy and enteroscopy are available for a precise diagnosis of GI involvement by a metastatic MM. The complete surgical resection of GI metastatic MM in carefully selected patients not only provides symptom control, but has also been associated with an increase in overall survival. The approval of BRAF-targeted therapies and immune checkpoint inhibitors has transformed therapeutic approaches for patients with metastatic MM over the past decade. Currently, the overall survival of patients with advanced metastatic MM who have been treated with a combination of immunotherapeutic agents reaches 52% at five years. The role of surgery for patients with the metastatic involvement of the GI tract with MM is evolving in the era of effective systemic treatments.
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27
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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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28
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Ng CY, Hayati F, Nadarajan C. Emphysematous gastritis after metastatic malignant melanoma: a radiological surprise. BMJ Case Rep 2020; 13:13/9/e235174. [PMID: 32912885 DOI: 10.1136/bcr-2020-235174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Malignant melanoma is cancer of the skin which commonly metastasises to the stomach. There have been no reported cases of emphysematous gastritis secondary to metastasis of malignant melanomas, to date. However, a 61-year-old woman with metastatic malignant melanoma of the left great toe presented to us with symptoms of severe left hypochondrium pain associated with high-grade fever, gross abdominal distension and recurrent vomiting. Two months earlier, metastasis was observed to have spread to the stomach and inguinal lymph nodes. At this stage, the patient opted for traditional medication instead of definitive surgery and chemotherapy. Radiological imaging revealed an emphysematous change to the stomach which was radiologically consistent with gastric malignant melanoma. Unfortunately, the patient succumbed to this rare condition.
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Affiliation(s)
- Chiak Yot Ng
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Firdaus Hayati
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Chandran Nadarajan
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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29
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Skafida E, Triantafyllopoulou I, Flessas I, Liontos M, Koutsoukos K, Zagouri F, Dimopoulos AM. Secondary Alopecia Neoplastica Mimicking Alopecia Areata following Breast Cancer. Case Rep Oncol 2020; 13:627-632. [PMID: 32774247 PMCID: PMC7383155 DOI: 10.1159/000507694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 11/19/2022] Open
Abstract
Cutaneous metastases from visceral carcinomas are relatively uncommon, with an overall incidence ranging from 0.7 to 9%. Diagnosis of scalp metastases usually escapes clinicians and dermatologists due to the fact that these metastases are mimicking other benign dermatological conditions. Herein, we present an uncommon case of scalp alopecia neoplastica mimicking alopecia areata due to breast cancer; a 43-year-old woman diagnosed with lobular cancer 3 years previously presented with acute loss of hair in well-circumscribed areas of the scalp and was diagnosed with alopecia areata by a private-practice dermatologist. She was then reevaluated, and due to her history of breast cancer, a biopsy from the scalp was performed and revealed alopecia neoplastica. At the same time that the skin lesions were recognized as disease involvement, the patient presented with dyspepsia, and endoscopy of the upper and lower gastrointestinal tract also revealed metastasis to the stomach and bowel. Gastrointestinal metastasis may occur with several types of cancer, but the stomach and bowel are rare metastatic sites for breast cancer.
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Affiliation(s)
- Efthymia Skafida
- Haematology-Oncology Unit, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | | | - Ioannis Flessas
- General and Breast Surgery Unit, General and Maternity Hospital "Helena Venizelou,", Athens, Greece
| | - Michael Liontos
- Haematology-Oncology Unit, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Konstantinos Koutsoukos
- Haematology-Oncology Unit, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Flora Zagouri
- Haematology-Oncology Unit, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
| | - Athanasios-Meletios Dimopoulos
- Haematology-Oncology Unit, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece
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30
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Iwai N, Okuda T, Harada T, Oka K, Hara T, Inada Y, Tsuji T, Komaki T, Dohi O, Yoshida N, Konishi H, Naito Y, Itoh Y, Kagawa K. Gastric Metastasis from Colorectal Cancer Mimicking a Submucosal Tumor. Case Rep Gastroenterol 2020; 14:338-345. [PMID: 32884508 PMCID: PMC7443688 DOI: 10.1159/000508414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/30/2020] [Indexed: 01/05/2023] Open
Abstract
Signet-ring cell carcinoma, a colorectal cancer (CRC) subtype, sometimes shows metastases to uncommon metastatic sites. However, gastric metastasis is extremely rare. Here, we describe a case of gastric metastasis from colonic cancer. A 76-year-old woman presented with anemia. Colonoscopic biopsy revealed a CRC on the transverse colon showing a poorly differentiated adenocarcinoma with a partial component of the signet-ring carcinoma. Computed tomography revealed multiple subcutaneous nodules on her chest and back, and a tumor in the left lower lobe of her lung. Esophagogastroduodenoscopy showed a submucosal tumor-like lesion in the upper gastric body, and endoscopic biopsy revealed the poorly differentiated adenocarcinoma along with the partial component of the signet-ring carcinoma as well as the colonic, subcutaneous, and pulmonary lesion. The findings of endoscopic and microscopic examinations revealed gastric metastasis from CRC on the transverse colon. A systemic chemotherapy was given, and the biopsy conducted 1 year after the initial chemotherapy revealed no evidence of the residual tumor tissue in the gastric lesion. However, best supportive care was recommended depending on metastasis to the rectum. Our case suggests that gastric metastases from CRC should be considered in patients with lesions resembling a submucosal tumor accompanied by central depression and erosion.
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Affiliation(s)
- Naoto Iwai
- Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital, Fukuchiyama-City, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takashi Okuda
- Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital, Fukuchiyama-City, Japan
| | - Taishi Harada
- Department of Medical Oncology, Fukuchiyama City Hospital, Fukuchiyama-City, Japan
| | - Kohei Oka
- Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital, Fukuchiyama-City, Japan
| | - Tasuku Hara
- Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital, Fukuchiyama-City, Japan
| | - Yutaka Inada
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshifumi Tsuji
- Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital, Fukuchiyama-City, Japan
| | - Toshiyuki Komaki
- Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital, Fukuchiyama-City, Japan
| | - Osamu Dohi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naohisa Yoshida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hideyuki Konishi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuji Naito
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keizo Kagawa
- Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital, Fukuchiyama-City, Japan
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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31
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Weissman S, Mehta TI, Zhornitskiy A, Tondon R, Tabibian JH. "Homomorphic" Tumor Metastases as an Endodiagnostic Clue: A Case Series of Renal-Cell Carcinoma Metastatic to the Stomach. Gastrointest Tumors 2019; 6:147-152. [PMID: 31768359 PMCID: PMC6873029 DOI: 10.1159/000502520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022] Open
Abstract
Distinguishing between a primary malignancy and a metastasis can be challenging in some cases. Herein, we describe 2 cases of gastric lesions that were endoscopically sampled and ultimately found to be metastatic from a renal-cell carcinoma. In both cases, the gastric metastases were endoscopically homomorphic to the primary organ (the kidney); i.e., grossly resembling and thus providing an endoscopic clue as to the primary tumor source. We report on the evaluation of obscure metastatic gastric involvement of malignancy and present the concept of homomorphism as a potential diagnostic clue in determining the source of unknown and often unsuspected primary malignancy.
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Affiliation(s)
- Simcha Weissman
- Department of Medicine, Palisades Medical Center, Hackensack University, North Bergen, New Jersey, USA
| | - Tej I. Mehta
- Department of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA
| | - Alex Zhornitskiy
- Department of Internal Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA
| | - Rashmi Tondon
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - James H. Tabibian
- Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA
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32
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Terashima S, Watanabe S, Kogure M, Tanaka M. Long-term survival after resection of a gastric metastasis from transverse colon cancer: a case report. Fukushima J Med Sci 2019; 65:37-42. [PMID: 31167978 DOI: 10.5387/fms.2018-24] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Metastatic neoplasms in the stomach from remote primary tumors are uncommon, and gastric metastases of colorectal origin are rare. We herein report a case of gastric metastasis originating from transverse colon cancer in a 61-year-old female patient. Curative right extended hemicolectomy and partial gastrectomy were performed. Histologically, both the colon and stomach tumors were moderately to poorly differentiated adenocarcinoma with similar features. The postoperative TNM classification was stage IV disease (T4N0M1). The patient received 7 cycles of postoperative bevasizumab+FOLFOX (oxaliplatin plus an infusion of 5-fluorouracil/levofolinate) therapy and 4 cycles of additional chemotherapy with bevacizumab+FOLFIRI (irinotecan plus an infusion of 5-fluorauracil/levofolinate).The patient has a good quality of life with no signs of recurrence at seven years and four months after surgery.
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33
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Peng Y, Liu Q, Wang Y, Song A, Duan H, Qiu Y, Li Q, Cui HJ. Pathological diagnosis and treatment outcome of gastric metastases from small cell lung cancer: A case report. Oncol Lett 2019; 18:1999-2006. [PMID: 31423270 PMCID: PMC6607122 DOI: 10.3892/ol.2019.10484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 04/25/2019] [Indexed: 01/30/2023] Open
Abstract
Small cell lung cancer (SCLC) is a type of lung cancer characterized by a rapid disease progression and poor prognosis. Its diagnosis is often accompanied by distant metastasis. A literature review revealed that metastases to the stomach from breast, lung and esophageal cancer are frequently reported. While SCLC is a common pathological subtype of lung cancer, literature on SCLC with gastric metastases is sporadic. The present study reviewed the literature using databases, including PubMed, WanFang Data and China National Knowledge Infrastructure, to analyze the clinicopathological features and outcome of patients with gastric metastases from SCLC. A total of 11 case reports and 6 retrospective studies comprising of 19 cases were compared and analyzed. In addition to the aforementioned studies, a case study describing a patient who survived for 10 months following a diagnosis of SCLC with gastric metastases is presented. The aim of the present study was to increase the understanding regarding the diagnosis and treatment of SCLC gastric metastasis.
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Affiliation(s)
- Yanmei Peng
- Department of Oncology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing 102400, P.R. China
| | - Qing Liu
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Ye Wang
- Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Aiping Song
- Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Hua Duan
- Department of Graduate Schools, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Yuqin Qiu
- Department of Graduate Schools, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Qiang Li
- Department of Graduate Schools, Beijing University of Chinese Medicine, Beijing 100029, P.R. China
| | - Hui-Juan Cui
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, P.R. China
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34
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A Rare Case of Gastric Metastasis in Ewing's Sarcoma of the Femur. Case Rep Oncol Med 2019; 2019:2870302. [PMID: 31218087 PMCID: PMC6537017 DOI: 10.1155/2019/2870302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/07/2019] [Indexed: 12/11/2022] Open
Abstract
The stomach is a very unusual site of metastasis. Published reports on metastatic lesion in the stomach is generally limited to single case reports and case series. Gastric metastasis in an Ewing's sarcoma is extremely rare and has been reported in English literature but once to our knowledge. We present a case report of Ewing's sarcoma of the right proximal femur metastasizing to the stomach. A young female treated for Ewing's sarcoma of the femur in 2012 presented with gastric metastasis after four years of disease-free interval. She was treated with irinotecan-based chemotherapy followed by total gastrectomy with esophagojejunal anastomosis and radiation therapy. At one-year follow-up, she was disease free.
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35
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De Gruttola I, Adil MT, D’Souza L, Jambulingam P, Whitelaw D. Perforated gastric carcinomatosis following invasive lobular cancer of the breast. Clin Case Rep 2019; 7:999-1002. [PMID: 31110734 PMCID: PMC6509928 DOI: 10.1002/ccr3.2116] [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: 10/11/2018] [Revised: 02/17/2019] [Accepted: 03/04/2019] [Indexed: 12/19/2022] Open
Abstract
Current guidelines do not advocate a routine search for gastric metastasis in known patients of breast cancer. This makes it challenging to suspect them clinically as they progress over many years. Gastric carcinomatosis from primary invasive lobular cancer can perforate leading to life-threatening abdominal emergency necessitating surgery.
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Affiliation(s)
- Ivan De Gruttola
- Department of Upper GI and Bariatric SurgeryLuton and Dunstable University HospitalLutonUK
| | - Md Tanveer Adil
- Department of Upper GI and Bariatric SurgeryLuton and Dunstable University HospitalLutonUK
| | - Lorraine D’Souza
- Department of PathologyLuton and Dunstable University HospitalLutonUK
| | | | - Douglas Whitelaw
- Department of Upper GI and Bariatric SurgeryLuton and Dunstable University HospitalLutonUK
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36
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Anaplastic Thyroid Carcinoma with Gastric Metastasis. CURRENT HEALTH SCIENCES JOURNAL 2018; 44:294-298. [PMID: 30647951 PMCID: PMC6311218 DOI: 10.12865/chsj.44.03.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/05/2018] [Indexed: 11/26/2022]
Abstract
Introduction. Carcinomas of the thyroid gland represent 3% of all malignancies, with 1.3 to 9.8% corresponding to
anaplastic thyroid carcinomas (ATC). Metastases are present in 50% of patients when ATC is diagnosed.
Gastrointestinal metastases are a rare finding in patients with thyroid carcinoma. Case report. A 68-year old
gentleman with a history of papillary thyroid carcinoma (PTC) underwent surgery and radiopharmaceutical therapy.
Restaging studies nine months later suggested wall thickening localizing to the distal stomach. Endoscopy results
showed a large, infiltrative, subepithelial, and ulcerated gastric mass and biopsies revealed anaplastic thyroid
carcinoma Conclusion. Incidental thickening or other findings in the stomach in a patient with ATC without
gastrointestinal symptoms should be further investigated with endoscopy and biopsies to rule out gastric
metastases from anaplastic thyroid carcinoma.
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37
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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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38
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Simões C, Carrilho-Ribeiro L, Velosa J. Gastric metastases of cervical carcinoma, rare cause of gastrointestinal bleeding. GASTROENTEROLOGIA Y HEPATOLOGIA 2018; 42:249-250. [PMID: 29866510 DOI: 10.1016/j.gastrohep.2018.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/16/2018] [Accepted: 04/25/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Carolina Simões
- North Lisbon Hospital Center - Hospital Santa Maria, Department of Gastroenterology, Lisboa, Portugal.
| | - Luís Carrilho-Ribeiro
- North Lisbon Hospital Center - Hospital Santa Maria, Department of Gastroenterology, Lisboa, Portugal
| | - José Velosa
- North Lisbon Hospital Center - Hospital Santa Maria, Department of Gastroenterology, Lisboa, Portugal
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39
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Sarocchi F, Gilg MM, Schreiber F, Langner C. Secondary tumours of the ampulla of Vater: Case report and review of the literature. Mol Clin Oncol 2017; 8:274-280. [PMID: 29435287 PMCID: PMC5776421 DOI: 10.3892/mco.2017.1535] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/23/2017] [Indexed: 12/18/2022] Open
Abstract
Secondary tumours of the ampulla of Vater are rare. Underlying primary tumours, clinical presentation, macroscopic appearance, treatment strategies and outcome of secondary ampullary lesions have not been systematically analysed. The present case study reported a 57-year old patient with an ampullary metastasis from renal cancer and a literature review was performed in which a further 32 patients were included. The most common responsible primary tumours were malignant melanoma and renal clear cell carcinoma, followed by breast cancer. The time interval between the diagnosis of the primary tumour and the ampullary metastasis was highly variable, and may be as long as 10 years, particularly for renal cancer. Patients may present with unspecific abdominal discomfort, jaundice or upper gastrointestinal bleeding. The gross appearance was largely indistinguishable from that of a primary tumour. Lesions may present as polypoid or irregular, soft and friable tumour mass, in certain cases with superficial ulceration. In ~50% of cases, the ampullary metastasis was the only metastatic lesion, while in the remaining cases, the cancer had spread to one or more organs. The prognosis was generally poor. The management requires a multi-modal approach, including endoscopic, surgical and oncological procedure.
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Affiliation(s)
- Francesca Sarocchi
- Institute of Pathology, Medical University of Graz, A-8036 Graz, Austria
| | - Magdalena M Gilg
- Institute of Pathology, Medical University of Graz, A-8036 Graz, Austria.,Department of Orthopedics and Trauma Surgery, Medical University of Graz, A-8036 Graz, Austria
| | - Florian Schreiber
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, A-8036 Graz, Austria
| | - Cord Langner
- Institute of Pathology, Medical University of Graz, A-8036 Graz, Austria
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40
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de Zárraga Mata C, Thomas Salom G, Vilella Martorell A, Salvà Ramonell F, Maura Oliver ÁL, Dolz Abadía C. Gastric metastatic extension of invasive ductal carcinoma of the breast with atypical endoscopic presentation. GASTROENTEROLOGIA Y HEPATOLOGIA 2017. [PMID: 28625415 DOI: 10.1016/j.gastrohep.2017.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Guiem Thomas Salom
- Servicio de Aparato Digestivo, Hospital Son Llàtzer, Palma de Mallorca, España
| | | | | | | | - Carlos Dolz Abadía
- Servicio de Aparato Digestivo, Hospital Son Llàtzer, Palma de Mallorca, España
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41
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Popa E, Schnoll‐Sussman F, Jesudian A, Nandakumar G, Shah MA. Uncommon Cancers of the Stomach. TEXTBOOK OF UNCOMMON CANCER 2017:395-415. [DOI: 10.1002/9781119196235.ch27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]
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42
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A case of gastric metastasis from renal cell cancer during the sequential targeted therapy. Int Cancer Conf J 2017; 6:114-117. [PMID: 31149483 PMCID: PMC6498289 DOI: 10.1007/s13691-017-0286-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 03/12/2017] [Indexed: 12/17/2022] Open
Abstract
Historically, gastric metastasis from renal cell cancer (RCC) has been extremely rare. As RCC is now being treated with various agents of targeted therapy, however, the rate of unusual visceral metastases might increase as outcomes improve and follow-up periods grow longer. Here we present a valuable case of gastric metastasis from RCC detected in a routine CT scan during sequential targeted therapy. A 73-year-old man was referred to our hospital, presenting with left renal cell cancer with multiple lung metastases at stage cT1bN0M1. He received first-line targeted therapy consisting of sunitinib and subsequently underwent left radical nephrectomy. He then underwent sequential therapy consisting of interferon-alpha, sunitinib, everolimus, and axitinib for multiple lung metastases. Five years after nephrectomy, a follow-up computed tomography scan revealed a 2.2 × 1.6 cm mass in the stomach without any symptoms. Gastrointestinal endoscopy disclosed a polypoid lesion at the gastric fundus. Endoscopic submucosal resection was performed. Microscopic diagnosis revealed gastric metastasis from RCC. As various new therapeutic agents increase survival periods for metastatic RCC patients in this era of targeted therapy, clinicians must watch for metastasis in the stomach, though this was formerly a rare event.
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43
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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: 9] [Impact Index Per Article: 1.0] [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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44
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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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Karrasch T, Doppl W, Roller FC, Schäffler A, Schäffer R, Gattenlöhner S. Unusual gastric mucosal infiltration by a medullary thyroid carcinoma: a case report. J Med Case Rep 2016; 10:208. [PMID: 27461534 PMCID: PMC4962496 DOI: 10.1186/s13256-016-0981-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/28/2016] [Indexed: 12/22/2022] Open
Abstract
Background Medullary thyroid carcinoma accounts for approximately 1 to 2 % of all thyroid carcinoma cases. The most common route of dissemination is to locoregional lymph nodes. Distant metastases commonly affect bones, lungs, and liver. We present a case of a white woman with a 25-year history of medullary thyroid carcinoma on multiple medications including tyrosine kinase inhibitor therapy for the last 11 months, who exhibited unusual diffuse infiltration of advanced stage medullary thyroid carcinoma to her gastric mucosa. Case presentation A 53-year-old white woman presented with increasing fatigue, loss of appetite, and severe epigastric pain radiating to her back. She had a history of medullary thyroid carcinoma (pT2pN1b), diagnosed 25 years ago and treated by complete thyroidectomy and repeated bilateral cervical lymph node dissection. Medical therapy included octreotide 20 mg every 4 weeks, which was switched to the tyrosine kinase inhibitor vandetanib 300 mg/day 11 months ago when computed tomography scanning revealed progressive mediastinal lymph node and diffuse and symptomatic pulmonary metastases. Of note, she demonstrated macroscopically stable pulmonary and mediastinal lymph node metastases; however, her calcitonin serum levels dramatically increased. Computed tomography scanning revealed a single new intrahepatic lesion (4 mm) as well as multiple (>10) new supraclavicular lesions suggestive of medullary thyroid carcinoma progress. As proven by gastric biopsy and immunohistochemical evaluation, her epigastric pain was explained by a diffuse infiltration of her gastric mucosa by metastatic medullary thyroid carcinoma. Subsequently, she rapidly deteriorated and died. Conclusions The current case report shows for the first time an unusual metastatic infiltration of the gastric mucosa by medullary thyroid carcinoma. When treating these patients, it is important to include this differential diagnosis during follow-up. Electronic supplementary material The online version of this article (doi:10.1186/s13256-016-0981-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- T Karrasch
- Department of Internal Medicine III, Giessen University Hospital, Klinikstrasse 33, 35392, Gießen, Germany.
| | - W Doppl
- Central Interdisciplinary Endoscopy Unit (ZIVE), Giessen University Hospital, 35392 Gießen, Germany
| | - F C Roller
- Department of Radiology, Giessen University Hospital, 35392 Gießen, Germany
| | - A Schäffler
- Department of Internal Medicine III, Giessen University Hospital, Klinikstrasse 33, 35392, Gießen, Germany
| | - R Schäffer
- Department of Pathology, Giessen University Hospital, 35392 Gießen, Germany
| | - S Gattenlöhner
- Department of Pathology, Giessen University Hospital, 35392 Gießen, Germany
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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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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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Tan HJ, Chan DYS, Seow CS. Isolated colorectal metastasis to the stomach 10 years after primary resection. Int J Colorectal Dis 2016; 31:1095-1096. [PMID: 26546441 DOI: 10.1007/s00384-015-2426-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Hiang Jin Tan
- Department of General Surgery, Ng Teng Fong General Hospital, Singapore, Singapore.
- MOHH, 1 Maritime Square, #11-25 Harbourfront Centre, 099253, Singapore, Singapore.
| | - Dexter Yak Seng Chan
- Department of General Surgery, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Choon Sheong Seow
- Department of General Surgery, Ng Teng Fong General Hospital, Singapore, Singapore
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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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