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Kohno S, Ikegami M, Yamamoto SR, Aoki H, Ogawa M, Yano F, Eto K. A rare case of colorectal metastasis found 8 years and 10 months after gastrectomy for advanced gastric cancer: A case report and literature review. Oncol Lett 2023; 25:203. [PMID: 37123025 PMCID: PMC10131265 DOI: 10.3892/ol.2023.13789] [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: 10/31/2022] [Accepted: 02/24/2023] [Indexed: 05/02/2023] Open
Abstract
Colorectal metastasis from gastric cancer is rare and may develop several years after gastric cancer surgery. Therefore, colonoscopic findings provide useful diagnostic information. The present report describes a case of gastric cancer colon metastasis diagnosed 8 years and 10 months after gastrectomy for advanced gastric cancer. A 64-year-old male patient underwent gastrectomy in December 2010 and received chemotherapy for 4 years and 10 months after the surgery. Subsequently, the patient was diagnosed as having colorectal cancer by computed tomography in February 2019. Colonoscopy revealed linitis plastica-like colon stenosis; however, biopsy pathology did not reveal any findings indicating malignancy. Right hemicolectomy was performed, and pathological examination revealed colon metastasis from gastric cancer. The patient received chemotherapy but died of peritoneal carcinomatosis 1 year and 8 months after the colectomy. According to literature, colorectal metastasis from gastric cancer is often attributed to hematogenous metastasis and often exhibits characteristic macroscopic features. Treatments, such as chemotherapy for gastric cancer and/or colorectal resection, are considered effective for gastric cancer colorectal metastasis.
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Affiliation(s)
- Shuzo Kohno
- Department of Surgery, The Jikei University Katsushika Medical Center, Tokyo 125-8061, Japan
- Correspondence to: Dr Shuzo Kohno, Department of Surgery, The Jikei University Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, Tokyo 125-8061, Japan, E-mail:
| | - Masahiro Ikegami
- Department of Pathology, The Jikei University Katsushika Medical Center, Tokyo 125-8061, Japan
| | - Se Ryung Yamamoto
- Department of Surgery, The Jikei University Katsushika Medical Center, Tokyo 125-8061, Japan
| | - Hiroaki Aoki
- Department of Surgery, The Jikei University Katsushika Medical Center, Tokyo 125-8061, Japan
| | - Masaichi Ogawa
- Department of Surgery, The Jikei University Katsushika Medical Center, Tokyo 125-8061, Japan
| | - Fumiaki Yano
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Ken Eto
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
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Janjic O, Labgaa I, Hübner M, Demartines N, Joliat GR. Metastasis to the rectum: A systematic review of the literature. Eur J Surg Oncol 2021; 48:822-833. [PMID: 34656391 DOI: 10.1016/j.ejso.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/07/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Metastatic spread to the rectum is a rare finding, and management of rectal metastases (RM) is not standardized. The aim of the present study was to review the evidence on diagnosis, management and outcomes of RM. METHODS A computerized literature search through MEDLINE/PubMed, Embase and the Cochrane databases was performed, applying a combination of terms related to RM. Articles and abstracts were screened and final selection was done after cross-referencing and by use of predefined eligibility criteria. RESULTS Final analysis was based on 99 publications totaling 162 patients with RM from 16 different primary tumors. Most common origins of RM were breast (42 patients), stomach (38 patients), and prostate (16 patients). RM occurred metachronously in the majority of patients (77%). The main treatment was surgical resection (n = 32), followed by chemotherapy (n = 16). Median overall survival for breast RM, stomach RM, and prostate RM were 24 months (95% CI 9-39 months), 7 months (95% CI 0-14 months), and 24 months (95% CI 7-41 months), respectively. CONCLUSION RM is a rare and highly heterogeneous condition. Surgical treatment appears to be a valuable treatment option in selected patients, while overall prognosis depends mainly on the primary tumor.
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Affiliation(s)
- Olivier Janjic
- Department of General Surgery, Münsingen Hospital, Inselgruppe, Bern, Switzerland
| | - Ismail Labgaa
- Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Martin Hübner
- Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Nicolas Demartines
- Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland.
| | - Gaëtan-Romain Joliat
- Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland
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Bates DDB, de Paula MCF, Horvat N, Sheedy S, Lall C, Kassam Z, Pickhardt P, Lalwani N, Ganeshan D, Petkovska I. Beyond adenocarcinoma: MRI of uncommon rectal neoplasms and mimickers. Abdom Radiol (NY) 2019; 44:3581-3594. [PMID: 31069482 DOI: 10.1007/s00261-019-02045-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To provide a review of rare rectal tumors beyond adenocarcinoma. RESULTS Rectal cancer is a common malignancy, both in the United States and abroad. In addition to adenocarcinoma, abdominal radiologists will encounter a variety of other less common rectal masses, both benign and malignant neoplasms as well as non-neoplastic mimickers. Familiarity with these conditions and their characteristic features on MRI is useful in clinical practice. In this article, a number of such conditions are discussed, with an emphasis on distinguishing features on MRI of the rectum. CONCLUSION Familiarity with the MRI features of rare rectal tumors beyond adenocarcinoma, as well as a small number of non-neoplastic mimics, is important for abdominal imagers to make diagnostic differentials and to assist in treatment planning.
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Baghaei K, Hosseinkhan N, Asadzadeh Aghdaei H, Zali MR. Investigation of a common gene expression signature in gastrointestinal cancers using systems biology approaches. MOLECULAR BIOSYSTEMS 2017; 13:2277-2288. [DOI: 10.1039/c7mb00450h] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
According to GLOBOCAN 2012, the incidence and the mortality rate of colorectal, stomach and liver cancers are the highest among the total gastrointestinal (GI) cancers.
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Affiliation(s)
- Kaveh Baghaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center
- Research Institute for Gastroenterology and Liver Diseases
- Shahid Beheshti University of Medical Sciences
- Tehran
- Iran
| | - Nazanin Hosseinkhan
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center
- Research Institute for Gastroenterology and Liver Diseases
- Shahid Beheshti University of Medical Sciences
- Tehran
- Iran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center
- Research Institute for Gastroenterology and Liver Diseases
- Shahid Beheshti University of Medical Sciences
- Tehran
- Iran
| | - M. R. Zali
- Gastroenterology and Liver Diseases Research Center
- Research Institute for Gastroenterology and Liver Diseases
- Shahid Beheshti University of Medical Sciences
- Tehran
- Iran
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Uemura N, Kurashige J, Kosumi K, Iwatsuki M, Yamashita K, Iwagami S, Baba Y, Sakamoto Y, Miyamoto Y, Yoshida N, Honda Y, Mikami Y, Baba H. Early gastric cancer metastasizing to the rectum, possibly via a hematogenous route: a case report and review of literature. Surg Case Rep 2016; 2:58. [PMID: 27271470 PMCID: PMC4896888 DOI: 10.1186/s40792-016-0180-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 05/29/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The most common pattern of recurrence of gastric cancer (GC) is peritoneal dissemination. However, rectal metastasis via hematogenous or lymphatic spread is exceedingly rare. We present a case of a 65-year-old man with an intramucosal GC who developed a rectal recurrence, possibly via a hematogenous route. CASE PRESENTATION A 65-year-old man underwent curative endoscopic submucosal dissections for the intramucosal GCs at the anterior wall of the fornix twice. The third GC at the similar location was treated by radical laparoscopic proximal gastrectomy; microscopic examination revealed well-differentiated tubular adenocarcinoma confined to the lamina propria mucosae (T1aN0M0, stage IA). Follow-up colonoscopy revealed a 30-mm submucosal mass in the rectal wall 2 years later, and a metastasis of gastric origin was suspected histopathologically. After a staging laparoscopy confirmed the absence of findings suggestive of serosal involvement or peritoneal dissemination, including negative peritoneal washing cytology, a laparoscopic low anterior resection with lymph node dissection was performed. Microscopically, the tumor was found to mainly be located in the submucosal layer and showed features of moderately differentiated tubular adenocarcinoma. The serosal surface was free of disseminated tumor. Lymph node metastases were identified. Immunohistochemically, there were foci of carcinoma cells that were positive for cytokeratin 20; however, they were negative for cytokeratin 7. Negative staining for caudal-type homeobox 2, a transcription factor indicating goblet cell differentiation, combined with absence of intramucosal carcinoma in the rectal mucosa, suggested a diagnosis of metastatic adenocarcinoma of gastric origin. The absence of evidence of peritoneal dissemination suggested hematogenous or lymphatic spread. CONCLUSION Although rectal metastasis from GC, particularly when attributable to hematologic or lymphatic metastasis, is very rare, metastatic gastric adenocarcinoma should be considered as a differential diagnosis for patients who present with a rectal tumor and a past history of GC, even if it is an early GC.
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Affiliation(s)
- Norio Uemura
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Junji Kurashige
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Keisuke Kosumi
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masaaki Iwatsuki
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kohei Yamashita
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Shiro Iwagami
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yoshifumi Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yasuo Sakamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yuji Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Naoya Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yumi Honda
- Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yoshiki Mikami
- Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
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Seow-En I, Seow-Choen F. Intestinal type gastric adenocarcinoma with unusual synchronous metastases to the colorectum and bladder. World J Clin Cases 2015; 3:533-537. [PMID: 26090375 PMCID: PMC4468901 DOI: 10.12998/wjcc.v3.i6.533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/14/2015] [Accepted: 04/14/2015] [Indexed: 02/05/2023] Open
Abstract
A 75-year-old male presented with difficult defecation and increasing urinary frequency over a few months. He had a significant history of previous partial gastrectomy for gastric carcinoma 20 years prior. Computed tomography of the abdomen and pelvis showed extensive lymphadenopathy, a gastric mass and rectal as well as bladder wall thickening with bilateral ureterohydronephrosis. Normal looking serosal surfaces of the bladder and bowel were seen on laparoscopy and a defunctioning ileostomy was created. Gastroscopy revealed a malignant mass while cystoscopy and sigmoidscopy found extensive tumour growth lining the mucosal surfaces. Biopsies from all sites were compatible with intestinal type adenocarcinoma of gastric origin with few signet ring cells. Metabolic response to palliative chemotherapy was good and the patient’s symptoms have improved on follow-up four months post ileostomy. We discuss the immunohistochemical profile of the tumour and review the literature.
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