scholarly journals Metastatic Gastric Adenocarcinoma of the Uterine Cervix – A Case Report and Review of the Literature

2021 ◽  
Author(s):  
Vishal Bahall ◽  
Lance De Barry ◽  
Mickhaiel Barrow ◽  
Rene Ramnarace
Keyword(s):  
Gastric Cancer ◽  
Gastric Adenocarcinoma ◽  
Uterine Cervix ◽  
Metastatic Cancer ◽  
Uterine Fibroids ◽  
Primary Source ◽  
Laparoscopic Hysterectomy ◽  
Diffuse Type ◽  
Primary Malignancy ◽  
Poorly Differentiated

Abstract Background: Poorly differentiated diffuse-type gastric adenocarcinoma typically presents at an advanced stage, however, metastasis to the uterine cervix is extremely rare. To our knowledge, less than forty cases have been described worldwide. Case presentation: We report a case of a 47-year-old woman who presented to us with symptomatic uterine fibroids and subsequently underwent a successful total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. The diagnosis of metastatic cancer involving the cervix was established incidentally on histopathology, which showed atypical signet ring cells in the lymphovascular spaces of the cervix. Further investigations for a primary malignancy revealed a poorly differentiated diffuse-type gastric adenocarcinoma. Conclusion: Gastric cancer involving the uterine cervix is rare and associated with a poor prognosis. When presented with isolated cervical metastases, the gastrointestinal tract should be considered as a possible primary source. Due to the limited publications on this clinical entity, we expect to raise awareness and study of this unique manifestation of gastric cancer by presenting our case.

scholarly journals Clinical Value of Energy Spectrum Curves of Dual-energy CT in Evaluating Pathological Grading of Gastric Adenocarcinoma

2019 ◽  
Author(s):  
Zhihua Lu ◽  
Suying Wu ◽  
Jianwei Chen ◽  
Chuan Yan ◽  
Yueming Li
Keyword(s):  
Gastric Cancer ◽  
Energy Spectrum ◽  
Gastric Adenocarcinoma ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Clinical Value ◽  
Pathological Differentiation ◽  
Dual Source ◽  
Venous Phase ◽  
Poorly Differentiated

Abstract Backgroud: Accurate diagnosis of cancer staging and pathological differentiation are critical for the formulation of individualized treatment and prognosis of gastric cancer. It is vital to explore non-invasive preoperative imaging techniques to evaluate the pathological differentiation degree of gastric cancer tissues, and provide better diagnostic basis and decision-making reference for treatment. The purpose of this study was to explore the clinical value of energy spectrum curves of dual-source dual-energy CT in the quantitative evaluation of different pathological grades of gastric adenocarcinoma. Methods: A total of 62 patients with 1 well, 25 moderately and 36 poorly differentiated gastric adenocarcinomas pathologically confirmed by surgery were collected, and they underwent dual-source dual-energy CT plain scanning and enhanced scanning before operation. Dual-Energy software was used to measure the slope of the energy spectrum curves (λ) in arterial and venous phases after image reconstruction. Patients were divided into two groups according to the pathological results, including well and moderately differentiated gastric adenocarcinoma group and poorly differentiated gastric adenocarcinoma group. Data of each group were analyzed by independent sample t-test. The receiver operating characteristic curve was plotted to evaluate the diagnostic efficiency of the corresponding parameters. Results: There were significant differences in λ values of 40-50keV, 40-60keV, 40-80keV, 40-90keV, 40-100keV, 40-120keV, 40-130keV, 40-140keV and 40-150keV energy ranges in venous phase between the well and moderately differentiated group and poorly differentiated group (P<0.05), but no significant differences in λ values of different energy ranges in arterial phase between the two groups (P>0.05). And the area under curve in 40-120keV energy range was the largest in venous phase. K40-120keV =2.69 was selected as the diagnostic threshold with the maximum Youden index, the sensitivity and specificity were 61.1% and 76%, respectively. Conclusion: The energy spectrum curve of dual-energy CT had certain diagnostic value in the quantitative evaluation of pathological grading of gastric adenocarcinoma.

Factors associated with recurrence in lymph node-negative gastric adenocarcinoma: Results from the U.S. Gastric Cancer Collaborative.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 80-80 ◽  
Author(s):  
Linda X. Jin ◽  
Malcolm Hart Squires ◽  
George A. Poultsides ◽  
Konstantinos Ioannis Votanopoulos ◽  
Sharon M. Weber ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Gastric Adenocarcinoma ◽  
Disease Recurrence ◽  
Curative Intent ◽  
Node Negative ◽  
T Stage ◽  
Predictors Of Recurrence ◽  
Poorly Differentiated ◽  
The U.S

80 Background: Lymph node (LN) status is a predictor of recurrence after gastrectomy for gastric adenocarcinoma. Clinicopathologic predictors of recurrence in patients with node-negative disease are less well established. Methods: Patients who underwent surgery with curative intent for gastric adenocarcinoma from between 2000-2012 from participating institutions of the U.S. Gastric Cancer Collaborative were analyzed. Patients who died within 30 days of surgery were excluded. Univariate (UV) and multivariate (MV) analysis of clinicopathologic factors was associated with recurrence was performed. Results: Nine-hundred sixty-five patients from seven institutions were included in the analysis. Three-hundred forty-five (36%) had LN- disease, of whom 63 (18%) had disease recurrence after a median follow-up of 24 months. The most common patterns of recurrence were: peritoneal alone (44%), liver (22%), or combined liver/peritoneal (9%). This distribution did not differ significantly from LN+ disease. UV analysis identified tumor size, linitis plastica, diffuse histology, poor differentiation, signet ring histology, T stage ≥3, perineural invasion, and lymphvascular invasion as risk factors for recurrence (Table). On MV analysis, T stage≥3 (OR 3.6, 95% CI=1.7-7.5) and poorly differentiated histology (OR 2.4, 95% CI=1.2-4.9) were independent predictors of recurrence. Conclusions: Despite the presence of negative lymph nodes, patients with T stage ≥3 and poorly differentiated histology are at high risk of recurrence after gastrectomy for adenocarcinoma of the stomach. These factors, along with other patient and treatment-related variables, may be used to select patients who may benefit from more aggressive adjuvant therapy and to guide subsequent monitoring for disease recurrence. [Table: see text]

scholarly journals Late, isolated metastasis from poorly differentiated gastric cancer to the uterine cervix

2014 ◽  
Vol 8 ◽  
pp. 17-20 ◽  
Author(s):  
Takuro Yamamoto ◽  
Taisuke Mori ◽  
Hiroshi Matsushima ◽  
Morio Sawada ◽  
Jo Kitawaki
Keyword(s):  
Gastric Cancer ◽  
Uterine Cervix ◽  
Poorly Differentiated

Don’t Give Up! Gastric Cancer; Poorly Differentiated Diffuse Type Carcinoma is Curable: A Case Report

2018 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ali Mirmansouri ◽  
Farnoush Farzi ◽  
Abbas Sedighinejad ◽  
Bahram Naderi Nabi ◽  
Gelareh Biazar
Keyword(s):  
Gastric Cancer ◽  
Case Report ◽  
Diffuse Type ◽  
Poorly Differentiated

scholarly journals Immune Cell Infiltrate and Prognosis in Gastric Cancer

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3604
Author(s):  
Niko Kemi ◽  
Niko Hiltunen ◽  
Juha P. Väyrynen ◽  
Vesa-Matti Pohjanen ◽  
Olli Helminen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Gastric Adenocarcinoma ◽  
Prognostic Value ◽  
Immune Cell ◽  
Cox Regression ◽  
Diffuse Type ◽  
Hazard Ratios ◽  
The Difference ◽  
Immune Cell Score

Purpose: To examine and compare the prognostic value of immune cell score (ICS) and Klintrup–Mäkinen (KM) grade in gastric cancer. Methods: Gastric adenocarcinoma tissues from samples of 741 patients surgically treated in two hospitals in Finland were assessed for ICS and KM grade. Cox regression with adjustment for confounders provided hazard ratios (HRs) and 95% CIs. Subgroup analyses were performed in intestinal and diffuse type subgroups. The primary outcome was 5-year overall survival. Results: High ICS was associated to longer 5-year survival (adjusted HR 0.70, 95% CI 0.52–0.94), compared to low ICS. The difference was significant in intestinal type subgroup (adjusted HR 0.54, 95% CI 0.36–0.81) but not in diffuse type subgroup (adjusted HR 0.92, 95% CI 0.58–1.46). High KM grade was an independent prognostic factor for longer 5-year overall survival (adjusted HR 0.59, 95% CI 0.45–0.77) in both intestinal (adjusted HR 0.61, 95% CI 0.44–0.85) and diffuse subgroups (adjusted HR 0.52, 95% CI 0.31–0.86). ICS and KM grade were moderately correlated (ρ = 0.425). When both immune cell score and KM grade were included in the regression analysis, only KM grade remained prognostic. Conclusions: Both ICS and KM grade are prognostic factors in gastric adenocarcinoma, but immunohistochemistry-based ICS might not have additional prognostic value over hematoxylin–eosin-based KM grade.

scholarly journals Genomic landscape of a mouse model of diffuse-type gastric adenocarcinoma

2021 ◽  
Author(s):  
Menghua Zhang ◽  
Itsuki Sugita ◽  
Daisuke Komura ◽  
Hiroto Katoh ◽  
Shu Shimada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Transcription Factors ◽  
Mouse Model ◽  
Gastric Adenocarcinoma ◽  
Copy Number ◽  
Conditional Knockout ◽  
Human Gastric Cancer ◽  
Diffuse Type ◽  
Gastric Cancers ◽  
Diffuse Type Gastric Cancer

Abstract Background There is a need for a model of diffuse-type gastric cancer that captures the features of the disease, facilitates the study of its mechanisms, and aids the development of potential therapies. One such model may be Cdh1 and Trp53 double conditional knockout (DCKO) mice, which have histopathological features similar to those of human diffuse-type gastric cancer. However, a genomic profile of this mouse model has yet to be completed. Methods Whole-genome sequences of tumors from eight DCKO mice were analyzed and their molecular features were compared with those of human gastric adenocarcinoma. Results DCKO mice gastric cancers harbored single nucleotide variations and indel patterns comparable to those of human genomically stable gastric cancers, whereas their copy number variation fraction and ploidy were more similar to human chromosomal instability gastric cancers (perhaps due to Trp53 knockout). Copy number variations dominated changes in cancer-related genes in DCKO mice, with typical high-level amplifications observed for oncogenic drivers, e.g., Myc, Ccnd1, and Cdks, as well as gastrointestinal transcription factors, e.g., Gata4, Foxa1, and Sox9. Interestingly, frequent alterations in gastrointestinal transcription factors in DCKO mice indicated their potential role in tumorigenesis. Furthermore, mouse gastric cancer had a reproducible but smaller number of mutational signatures than human gastric cancer, including the potentially acid-related signature 17, indicating shared tumorigenic etiologies in humans and mice. Conclusions Cdh1/Trp53 DCKO mice have similar genomic features to those found in human gastric cancer; hence, this is a suitable model for further studies of diffuse-type gastric cancer mechanisms and therapies.

scholarly journals Uterine cervix squamous cell carcinoma metastatic to the Ampulla of Vater: a case report with review of the literature

2013 ◽  
Vol 3 (2) ◽  
pp. 173-176
Author(s):  
Dalma Udovčić Gagula ◽  
Faruk Skenderi ◽  
Srđan Gornjaković ◽  
Nermina Ibišević ◽  
Adisa Chikha ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Uterine Cervix ◽  
Metastatic Cancer ◽  
Ampulla Of Vater ◽  
Ampullary Carcinoma ◽  
Review Of The Literature ◽  
Diagnostic Challenge ◽  
Poorly Differentiated

Metastases to gastrointestinal tract are uncommon. In particular, metastases to the ampulla of Vater are very rare and may represent a significant diagnostic challenge. Metastases from the uterine cervix to the ampulla of Vater are exceedingly rare and only one case has been described in the available literature. We describe here a second case of metastatic squamous cell carcinoma of the cervix to the ampulla of Vater in a 45-year-old woman. Poorly differentiated squamous cell carcinoma presented as an isolated metastasis to the ampulla of Vater, two years after the initial diagnosis. While the squamous cell carcinoma could occur as primary ampullary carcinoma, albeit very rare, it is necessary to exclude the possibility of metastatic cancer.

scholarly journals Incidence of human epidermal growth factor receptor-2 expression and its correlation with clinicopathological characteristics in gastric cancer at tertiary care centre at IGMC Shimla, Himachal Pradesh, India

2017 ◽  
Vol 4 (5) ◽  
pp. 1715
Author(s):  
Vishal Thakur ◽  
Puneet Mahajan ◽  
Neelam Sharma ◽  
Ved Kumar Sharma ◽  
Tushar Patial ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Gastric Adenocarcinoma ◽  
Locally Advanced ◽  
Growth Factor Receptor ◽  
Clinicopathological Characteristics ◽  
Poorly Differentiated ◽  
Her 2 ◽  
Epidermal Growth

Background: Trastuzumab has been approved for the treatment of patients with HER-2 positive metastatic/locally advanced adenocarcinoma of the stomach by FDA.1 Most of gastric cancer patients present at an advanced stage in our country, all patients of gastric adenocarcinoma should be subjected to HER-2 testing at initial diagnosis. Immunohistochemistry should be the initial testing methodology and Fluorescence in-situ hybridization should be used to retest immunohistochemistry 2+ samples.Methods: We conducted this study with the aim to establish the expression profile of HER-2 and its correlation to clinicopathological characteristics in resectable cases of gastric adenocarcinoma, in patients presenting with gastric adenocarcinoma at IGMC Shimla. The study was conducted over a year from 1st July 2014 to 30th June 2015. Sample size included 40 diagnosed cases of resectable gastric adenocarcinoma. All patients with operable and resectable disease were subjected to surgery and the specimen were sent for detailed histopathological examination and immunohistochemistry . χ 2 statistical analysis was performed to assess the HER-2 positivity rate . All statistics were performed using 2-sided analysis, with a significance level of p< 0.05.Results: In our study , 7 cases (17.5%) were scored as strongly positive for HER-2 membrane staining (3+), 4 cases (10%) were moderately positive (2+) and 29 cases (72.5%) were HER-2 negative (0/1+) on IHC. The positivity rates in diffuse type (22.2%) and poorly-differentiated (25%) gastric cancer were higher than those in intestinal type (9.9%) and well-differentiated (14.3%) gastric cancer respectively.Conclusions: There is a strong association of human epidermal growth factor receptor-2 positivity with Gastric Malignancy in our country especially in poorly differentiated cancers. Targeted biological therapy with Trastuzumab hence becomes an attractive addition to the multimodality therapy usually required in the treatment of locally advanced /metastatic gastric cancers.

scholarly journals A rare case of PSA-negative metastasized prostate cancer to the stomach with serum CEA and CA19-9 elevation: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Koji Shindo ◽  
Kenoki Ohuchida ◽  
Taiki Moriyama ◽  
Fumio Kinoshita ◽  
Yutaka Koga ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gastric Cancer ◽  
Rare Case ◽  
Metastatic Cancer ◽  
Gastric Tumor ◽  
Pathological Examination ◽  
Poorly Differentiated Adenocarcinoma ◽  
Primary Gastric Cancer ◽  
Poorly Differentiated ◽  
Metastatic Gastric Tumor

Abstract Background Metastatic cancer to the stomach is relatively rare. Prostate-specific antigen (PSA) is a reliable biomarker used in the screening and management of patients with prostate cancer. However, it is difficult to definitively diagnose a PSA-negative metastatic gastric tumor of prostate cancer because the cancer sometimes resembles primary gastric cancer in clinical images. It is also difficult to distinguish metastatic cancer from primary cancer even in the pathological examination of biopsy samples when the lesion is poorly differentiated adenocarcinoma. There is a possibility that the characteristics of the cancer are changed during treatment such as chemotherapy or radiation therapy. Therefore, careful consideration is required for surgical indication. Case presentation A 60-year-old male underwent radical prostatectomy and subsequent radiation therapy for advanced prostate cancer (pT3N1M0) 10 years previously, and hormone therapy was started for metachronous multiple bone metastasis 10 months before. Upper gastrointestinal endoscopy revealed an irregular depressed lesion with a convergence of folds at the greater curvature of the upper gastric body. Biopsy showed poorly differentiated adenocarcinoma that was negative for PSA upon immunohistochemistry. He had high serum carcinoembryonic antigen (CEA) (946.1 ng/ml) and carbohydrate antigen 19-9 (CA19-9) (465.1 U/ml) levels with no elevation of PSA (0.152 ng/ml). The tumor was diagnosed as primary gastric cancer based on the clinical imaging and pathological examination of the biopsy sample including the PSA staining. Based on the diagnosis, laparoscopic proximal gastrectomy with lymphadenectomy was performed. However, pathological examination of the resected specimen revealed poorly differentiated adenocarcinoma that was positive for other prostate markers such as androgen receptor. Thus, the patient was diagnosed with metastasized prostate cancer to the stomach. Conclusions We report a case of metastatic gastric cancer of prostate cancer 10 years after radical prostatectomy. In the present case, it was difficult to diagnose a metastatic gastric tumor of prostate cancer preoperatively, because of its resemblance to primary gastric cancer without PSA expression and no serum PSA elevation. Although a rare case entity, it is important to consider the possibility of a metastatic gastric tumor when the surgical indication is determined in cases with another co-existing cancer.

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