Disseminated cutaneous nodules revealing gastric carcinoma

Intracranial hypertension as the primary symptom of gastric signet-ring cell carcinoma: A case report and literature review

BACKGROUND

Intracranial hypertension (IH) is a neurological disorder characterized by increased intracranial pressure. It is a poorly understood syndrome that most commonly manifests nonspecific symptoms such as stroke-like headache, vision changes, nausea, vomiting, and papilledema. IH has been reported in young cancer patients but never in association with gastric signet-ring cell carcinoma.

METHODS

Here, we discuss the case of an 18-year-old girl with gastric signet-ring cell carcinoma in which IH was the primary symptom accompanied by the even rarer symptom of cutaneous metastases. We also present a review of the relevant literature. The patient experienced frequent headaches, vomiting, and blurred vision but showed no abnormal findings on cranial imaging studies. Further examination showed multiple skin nodules on the abdomen. Then pathological and immunohistochemical examination of gastroscopic specimens and the biopsied subcutaneous nodules were done.

RESULTS

Pathological and immunohistochemical examination of gastroscopic specimens and the biopsied subcutaneous nodules confirmed gastric signet-ring cell carcinoma with skin metastases.

CONCLUSION

To our knowledge, this is the first reported case of gastric signet-ring cell carcinoma primarily presenting IH and accompanied by subcutaneous metastases. This case emphasizes the importance of excluding malignancy from the differential diagnosis of IH.

Metastatic gastric adenocarcinoma presenting as a solitary plaque on the palm

Cutaneous metastases from gastric adenocarcinoma are extremely rare. When present, metastasis typically signifies disseminated disease with a poor prognosis. We report a case of an 80-year-old male with gastric cancer who presented with a single, erythematous plaque on the left palm, a very rare site for skin metastasis. Results of a skin biopsy demonstrated that the cutaneous metastasis originated from the stomach. This report emphasized the need for appropriate investigation into newly appearing, unusual, or persistent skin lesions.

Cutaneous metastasis from a presumed signet-ring cell carcinoma in a 10-year-old child

Cutaneous metastases of internal malignancies are very rare in children. In this group, neuroblastoma, leukaemia and lymphoma are the most common malignancies that may develop metastases or neoplastic infiltrates to the skin. Carcinomas have infrequently been reported in children, and cutaneous metastases from carcinoma in this group have not been described. A 10-year-old girl presented with an erythematous plaque on the left hemithorax. Histopathological findings revealed grouped signet-ring cells within the lumina of lymphatic vessels in the dermis. Immunohistochemical examination confirmed the epithelial origin of the tumour. Despite an exhaustive search, the primary site could not be determined. This exceptional observation is, to the best of our knowledge, the first report of cutaneous metastasis from occult carcinoma in a child.

Cutaneous metastatic disease

The relative frequencies of cutaneous metastases are similar to those of the primary cancers; breast, colon, and melanoma are the most frequent in women and lung, colon, and melanoma are the most common in men. Cutaneous metastases represent an opportunity to detect a potentially treatable cancer before other evidence of it is present, to modify therapy as appropriate to the tumor stage, or possibly to use the cutaneous lesion as a source of easily accessible tumor cells for specific therapy. Cutaneous metastatic disease as the first sign of internal cancer is most commonly seen with cancer of the lung, kidney, and ovary.