Sigmoid colonic metastasis by lymphatic spread occurring with unilateral Krukenberg tumor considered to be caused by stage IA early gastric cancer: A case report

A rare case of colorectal metastasis found 8 years and 10 months after gastrectomy for advanced gastric cancer: A case report and literature review

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.

Simultaneous colonic metastasis of advanced gastric cancer: a case report

BACKGROUND

Although distant metastasis in gastric cancer can be present at the time of the initial diagnosis, colonic metastasis is extremely rare. This report describes a case of simultaneous colonic metastasis of advanced gastric cancer.

CASE PRESENTATION

The patient was a 78-year-old woman with nausea and epigastric pain. Upper gastrointestinal endoscopy revealed an advanced invasive ulcerative tumor in the lesser curvature of the stomach extending from the anterior to the middle portion. Colonoscopy revealed a 4-mm polyp-like lesion in the mid-transverse colon; therefore, a polypectomy was performed. Both gastric and colonic tumors showed poorly differentiated adenocarcinoma with signet ring cell carcinoma. After providing informed consent, the patient underwent a total gastrectomy. Histologic examination showed similar morphologic features of both gastric and colonic tumors. Immunohistochemistry staining showed that these tumor cells were positive for cytokeratin (CK) 7 and negative for CK20.

CONCLUSIONS

This was an extremely rare case of simultaneous colonic metastasis of advanced gastric cancer. Because missed metastasis can result in a poorer prognosis, we propose a systemic search including colonoscopy for patients with advanced gastric cancer, especially cases involving poorly differentiated adenocarcinoma or signet ring cell carcinoma.

Frequency and therapeutic strategy for patients with ovarian metastasis from gastric cancer

PURPOSE

This study aimed to analyze the clinicopathological features and treatment outcomes of ovarian metastasis from gastric cancer.

METHODS

This study included 155 female patients with unresectable advanced or recurrent gastric cancer at the Kochi Medical School between January 2007 and December 2021. A review of patients with ovarian metastasis was conducted, and their clinicopathological information and survival outcomes were compared with respect to ovarian metastasis.

RESULTS

Fifteen patients were diagnosed with ovarian metastasis from gastric cancer with a median age of 54 years (range: 30-87 years) and an incidence of 9.7%. The median age of patients who developed ovarian metastasis was significantly lower those without ovarian metastasis (54 years vs. 71 years, P = 0.014). The median survival time (MST) for 15 patients with unresectable advanced gastric cancer who developed ovarian metastasis was 21.4 months (range: 0.2-41.4 months). The MST for 15 patients who underwent surgical resection and systemic drug treatment including chemotherapy to ovarian metastasis was significantly higher than those who received systemic drug treatment alone (28.1 months vs. 10.0 months; P = 0.021).

CONCLUSION

Ovarian metastasis was found in 9.7% of female patients with unresectable advanced or recurrent gastric cancer and in younger patients than in those without ovarian metastasis. Multidisciplinary treatment, including surgical resection and systemic drug treatment for ovarian metastasis from gastric cancer, may benefit selected patients.

Gastric cancer with repeated metastasis in the colonic lumen: a case report and multi-surgical experience

Poorly differentiated gastric adenocarcinoma is commonly associated with lymph node metastasis, peritoneal spread, and liver metastasis but rarely with intraintestinal metastasis. Most patients with metastatic gastric carcinoma are unable to undergo surgical treatment and have a poor prognosis. A 42-year-old man with hunger-related abdominal pain was diagnosed as having gastric cancer. After the first surgery (distal partial gastrectomy) and the second surgery (gastric stump carcinoma (GSC) resection), the patient suffered repeated multiple intracolonic metastases and underwent three additional resection operations. The patient survived for 154 months after the first operation. In patients with gastric carcinoma that metastasizes to the colonic lumen, radical resection, if possible, can extend survival. Once patients develop extensive extraintestinal metastasis, radical resection cannot be performed, and patients often exhibit a poor prognosis.

Colonic Metastases from a Luminal A Type Invasive Ductal Carcinoma Breast: A Rare Case Report

Metastatic carcinoma breast involving hepatobiliary system and peritoneum is a common and well-described entity. However, colonic luminal involvement by breast metastases is rare and its early recognition is important for accurate management planning. We report a case of an elderly woman with luminal A type invasive ductal carcinoma (IDC) breast, initially controlled/stabilized on hormonal treatment and later progressed to involve colon presenting with intestinal obstructive symptoms. Lobular carcinoma breast which constitutes around 10% of breast cancers is more likely to have gastrointestinal tract (GIT) involvement. On the other hand, GIT metastasis from IDC breast is quite rare. Given the progressively increasing survival with current and forthcoming novel treatment modalities, it is very important to recognize and understand unusual presentation of metastatic breast cancer, such as colonic metastasis, for timely treatment planning and implementation.

Colonic Metastases from a Luminal A Type Invasive Ductal Carcinoma Breast: A Rare Case Report

Metastatic carcinoma breast involving hepatobiliary system and peritoneum is a common and well-described entity. However, colonic luminal involvement by breast metastases is rare and its early recognition is important for accurate management planning. We report a case of an elderly woman with luminal A type invasive ductal carcinoma (IDC) breast, initially controlled/stabilized on hormonal treatment and later progressed to involve colon presenting with intestinal obstructive symptoms. Lobular carcinoma breast which constitutes around 10% of breast cancers is more likely to have gastrointestinal tract (GIT) involvement. On the other hand, GIT metastasis from IDC breast is quite rare. Given the progressively increasing survival with current and forthcoming novel treatment modalities, it is very important to recognize and understand unusual presentation of metastatic breast cancer, such as colonic metastasis, for timely treatment planning and implementation.

Metastatic Gastric Signet Ring Cell Adenocarcinoma Presenting With Colonic Stenosis

Metastases to the colon are rare and may mimic other diseases such as inflammatory bowel disease. This differential diagnosis is often overlooked by endoscopists which leads to unnecessary diagnostic delay or inappropriate treatment. We present a case of a 54-year-old woman who presented with ascites. Malignant cells were demonstrated on cytologic examination of ascitic fluid, but no primary tumour or metastases were seen on computed tomography of the abdomen. On colonoscopy, an impassable stenosis was found in the transverse colon with scattered patches of oedematous colonic mucosa through to the mid-descending colon. Histological examination revealed scattered signet ring cells and the diagnosis of gastric signet ring cell adenocarcinoma was confirmed with subsequent gastroscopy. The correct and timely diagnosis of metastatic lesions to the colon requires a high index of suspicion and adequate mucosal sampling with multiple biopsies.

Colonic Metastases from a Luminal A Type Invasive Ductal Carcinoma Breast: A Rare Case Report

Metastatic carcinoma breast involving hepatobiliary system and peritoneum is a common and well-described entity. However, colonic luminal involvement by breast metastases is rare and its early recognition is important for accurate management planning. We report a case of an elderly woman with luminal A type invasive ductal carcinoma (IDC) breast, initially controlled/stabilized on hormonal treatment and later progressed to involve colon presenting with intestinal obstructive symptoms. Lobular carcinoma breast which constitutes around 10% of breast cancers is more likely to have gastrointestinal tract (GIT) involvement. On the other hand, GIT metastasis from IDC breast is quite rare. Given the progressively increasing survival with current and forthcoming novel treatment modalities, it is very important to recognize and understand unusual presentation of metastatic breast cancer, such as colonic metastasis, for timely treatment planning and implementation.

Two rare cases of synchronous and metachronous colonic metastases in patients with advanced gastric cancer

Background

Patients with advanced gastric cancer (GC) may ultimately die because GC mostly leads to synchronous or metachronous metastasis. However, colonic metastasis of GC is extremely rare. According to a PubMed search of papers published from May 1968 to March 2017, only 21 patients with GC (10 patients from 10 case reports and 11 patients from a retrospective study) have been found to have colonic metastasis. In this report, we present two cases of synchronous and metachronous colonic metastases of advanced GC.

Case presentation

Two patients with advanced GC received a diagnosis of colonic metastasis based on colonoscopic findings and computed tomography images, and the diagnosis was confirmed through pathological immunohistochemical analysis. Herein, we describe the management and outcomes of these metastases.

Conclusions

Submucosal swelling and segmental bowel wall thickening observed through colonoscopy in patients with advanced GC might indicate colonic metastasis.

Lymphogenous metastasis to the transverse colon that originated from signet-ring cell gastric cancer: A case report and review of the literature

Metastases to the colon are rare and a high-frequency primary region is the stomach. In cases of metastases to the colon, the morphological type of the metastatic region is mostly the infiltrating type of poorly differentiated or undifferentiated adenocarcinoma with lymph and blood vessel invasion. A case of cancer metastasis to the transverse colon that originated from advanced gastric cancer, which shows the difficulties in the precise diagnosis of metastases to the colon, is presented. In the present case, the gastric carcinoma was determined to be an advanced infiltrative ulcerative adenocarcinoma and the colon carcinoma was determined to be a superficial depressed adenocarcinoma. After surgery, the colon carcinoma was diagnosed as a metastatic adenocarcinoma from gastric adenocarcinoma with high invasion of vessels, by immunohistopathological analysis of CK7, CK20, p53 and HER-2. In this report, previously reported cases of metastases to the colon from gastric cancer were reviewed and their morphological characteristics were analyzed.

An Unusual Evolution of Krukenberg Tumour: A Case Report

Krukenberg tumours are rare metastatic tumours of the ovaries characterized by the presence of mucin-producing neoplastic Signet Ring Cell Carcinoma (SRCC). At first glance, this tumour may be confused with a primary ovarian tumour. Surgery and chemotherapy combination have led to improvement in prognosis, but it still remains severe. We report the case of a 60-year-old woman with a Krukenberg tumour rising from a low differentiated gastric adenocarcinoma. The patient was clinically stable for 26 months after surgery until she experienced a prompt decline and died of cerebral haemorrhage within two weeks. The aim of this article was to give an overview of the Krukenberg tumour starting from our case report and comparing it with clinicopathological characteristics of this pathology derived from a review of recent literature.