Gastric Metastasis from Colorectal Cancer Mimicking a Submucosal Tumor

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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Signet ring cell carcinoma and poorly differentiated adenocarcinoma in a gastric hyperplastic polyp with lymphatic invasion: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2019.10.019 ◽

2019 ◽

Vol 64 ◽

pp. 180-183

Author(s):

Kazuya Takahashi ◽

Shin Saito ◽

Yuki Kaneko ◽

Shiro Matsumoto ◽

Hironori Yamaguchi ◽

...

Keyword(s):

Case Report ◽

Hyperplastic Polyp ◽

Signet Ring Cell Carcinoma ◽

Lymphatic Invasion ◽

Signet Ring Cell ◽

Poorly Differentiated Adenocarcinoma ◽

Signet Ring ◽

Poorly Differentiated ◽

Ring Cell ◽

Gastric Hyperplastic Polyp

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Applicability of endoscopic submucosal dissection for undifferentiated early gastric cancer: Mixed histology of poorly differentiated adenocarcinoma and signet ring cell carcinoma is a worse predictive factor of nodal metastasis

Surgical Oncology ◽

10.1016/j.suronc.2016.12.001 ◽

2017 ◽

Vol 26 (1) ◽

pp. 8-12 ◽

Cited By ~ 14

Author(s):

In Seob Lee ◽

Sol Lee ◽

Young Soo Park ◽

Chung Sik Gong ◽

Jeong Hwan Yook ◽

...

Keyword(s):

Gastric Cancer ◽

Signet Ring Cell Carcinoma ◽

Nodal Metastasis ◽

Signet Ring Cell ◽

Poorly Differentiated Adenocarcinoma ◽

Undifferentiated Early Gastric Cancer ◽

Signet Ring ◽

Poorly Differentiated ◽

Ring Cell ◽

Mixed Histology

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A Case of Poorly Differentiated Adenocarcinoma with Signet Ring Cell Carcinoma of the Duodenal Bulb: A Case Report

International Surgery ◽

10.9738/intsurg-d-17-00043.1 ◽

2017 ◽

Vol 102 (3-4) ◽

pp. 141-144 ◽

Cited By ~ 1

Author(s):

Kosuke Hirano ◽

Yukinori Yamagata ◽

Teppei Tatsuoka ◽

Yawara Kubota ◽

Kazuyuki Saito ◽

...

Keyword(s):

Cell Carcinoma ◽

Rare Case ◽

Case Reports ◽

Duodenal Bulb ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Poorly Differentiated Adenocarcinoma ◽

Signet Ring ◽

Poorly Differentiated ◽

Ring Cell

Duodenal cancers are rare. Histopathologically, most duodenal cancers are adenocarcinoma. Signet ring cell carcinoma (SRCC) is a rare tumor more commonly found in the stomach than at other sites in the digestive tract. SRCC is extremely uncommon in the duodenum, with most of these tumors occurring in the ampulla. Until now, there are few case reports of duodenal cancers with SRCC. To accumulate case reports, we report a rare case of nonampullary duodenal bulb SRCC. A 74-year-old man was admitted to our hospital with melena. Esophagogastroduodenoscopy (EGD) showed a duodenal bulb ulcer. He was treated with a proton pump inhibitor. However, 1 month later, he was readmitted to our hospital with epigastric pain and nausea. A second EGD examination showed an ulcer at the duodenal bulb. Biopsies taken from the ulcer showed SRCC. Distal gastrectomy and duodenal bulb resection were performed. Histologic examination of the specimen showed a type 4 lesion located from the duodenal bulb to the pyloric antrum. The tumor was composed of poorly differentiated adenocarcinoma (por) with SRCC. The distal margin of the duodenal bulb was invaded with tumor. Therefore, pancreatoduodenectomy was performed. One year after the initial operation, he is alive and had no relapse. We described a rare case of por with SRCC of the duodenal bulb. It is important to bear in mind that an ulcer following an abnormal clinical course should be biopsied, and we have to select a suitable operation in cases of duodenal bulb cancer.

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