Metastasis of Testicular Choriocarcinoma in the Stomach, Complicated by the Development of Choriocarcinoma Syndrome

Choriocarcinoma (CC) is a very rare and aggressive neoplasm. The characteristic feature of this disease is a rapid hematogenous spread, mainly to the lungs and brain, which largely defines clinical signs of the disease and complicates the diagnosis. Gastrointestinal metastases are rare, and of those, only few cases with gastric location have been reported. There are publications describing choriocarcinoma syndrome (CCS). As a rule, it presents in patients with an advanced disease and is characterized by hemorrhage from metastatic foci, leading to hemoptysis and gastrointestinal bleeding. CCS development is associated with poor prognosis and high mortality. This article describes a case of testicular CC with rare few gastric metastases, complicated by CCS.

Pathochistological and immunohistochemical study in small intestine metastasis as first clinical expression of invasive lobular breast carcinoma: Prognosis and complex treatment

The gastrointestinal metastases (GIM) of breast carcinoma (BC) are a rare clinical finding, even more rarely diagnosed as initial symptoms at unknown BC. We present a 50-year-old woman with metastases in the terminal ileum combined with multiple bone metastases from an unknown invasive carcinoma of left mammary gland. Gastrointestinal metastases are rarely observed in invasive lobular breast carcinoma. Differential diagnosis between intestinal metastases from primary BC and primary intestinal neoplasm is extremely difficult. Determination of tumor pathohistogenesis require careful pathohistological and immunohistochemical analysis. Complex treatment follows the primary neoplasm principles. The prognosis in such clinical cases is unfavorable, but after timely complex oncological treatment, including emergency operation, chemotherapy, hormone and target therapy, 36 monthly survival is achieved. Keywords: gastrointestinal metastases; invasive lobular breast carcinoma; pathohistological analysis; immunohistochemical analysis; complex treatment.

Primary pulmonary invasive mucinous adenocarcinoma with sigmoid colon metastasis:a case report and literature review

Background: Invasive mucinous carcinoma is a very rare tumor. The colonic metast-asis of IMA is more infrequent. So far, no literatures are published. Case presentation: We report a case of a patient with invasive mucinous adenocarci-noma. After serial months of chemitherapy, the sigmoid colonic metastasis was detected.Conclusions: Symptoms and CT findings can initially be subtle, histological examination remains the gold standard for the definitive diagnosis. Patients with high grade primary lung cancer may have gastrointestinal metastases, therefore their gastrointestinal should be examined to allow early detection and treatment.

Peritonitis from perforated sigmoid mass as the first manifestation of metastatic squamous cell lung cancer: a case report and review of literature

Lung cancer (LC) is an aggressive malignancy with early metastatic spread and poor prognosis. Gastrointestinal metastases from primary LC are extremely rare with highly variable presentations. In this report, we review the case of a patient who presented with peritonitis secondary to perforated sigmoid mass as the first manifestation of metastatic squamous cell LC.

Case Report and Literature Review: Unusual Presentation of Genitourinary & Gastrointestinal Metastases from Invasive Lobular Carcinoma of the Breast

Unlike invasive ductal carcinoma, lobular carcinoma exhibits a distinct metastatic pattern. It is likely to spread to gynecological organs, peritoneum, retroperitoneum, brain and gastrointestinal tract in comparison to ductal carcinoma, which spreads to liver, lung, and brain tissues. The diagnosis becomes more unlikely on the rare occasion when it represents the first manifestation of breast cancer. It is important to differentiate the metastasis from primary carcinoma of genital or GI tract as the management substantially differs. In this report; we present a 47 years-old female patient who presented with gynecological organs & gastrointestinal tract involvement as initial presentation and literature review done for these unusual sites of metastasis.

Clinical Characteristics and Prognosis of Gastrointestinal Metastases in Solid Tumor Patients: A Retrospective Study and Review of Literatures

Background. According to the literature and our experience, patients with gastrointestinal metastases are relatively rare. Numerous case reports and literature reviews have been reported. We present one of the larger case series of gastrointestinal metastases. Objectives. To explore the clinical characteristics and prognosis of patients with gastrointestinal tract metastases, which are rare metastatic sites. Methods. Patients with gastrointestinal metastases in the setting of stage IV primary carcinomas treated at Beijing Ditan Hospital and Peking University International Hospital from November 1992 to August 2017 were included in this study. The diagnosis of gastrointestinal tract metastases was based on histopathology. Results. 30 patients (median age 56 years, 56.7% female) were included. The most common primary carcinomas associated with gastrointestinal metastases were breast (11 patients, 36.7%), stomach (9 patients, 30.0%), and lung (4 patients, 13.3%) cancer. The major pathological types were adenocarcinoma (16 patients, 53.3%) and ductal carcinoma (9 patients, 30.0%). Ten patients (33.3%) underwent local gastrointestinal treatment, and 20 patients (66.7%) underwent nonlocal treatment (involving chemotherapy alone or best supportive care). For breast cancer patients and gastric cancer patients who underwent local therapy, a significant survival advantage was observed (p=0.001 and p=0.012, respectively). The presence of other common metastases was identified as an independent poor prognostic factor through multivariate analysis with a HR (hazard ratio) of survival of 0.182 (95% confidence interval (CI) 0.11-0.523, p=0.031). Conclusion. Gastrointestinal metastases are most frequently from breast invasive ductal carcinoma. The presentation of other common metastases with gastrointestinal metastasis indicates poor prognosis, and selected patients may benefit from surgical intervention.

Upper Gastrointestinal Bleed due to Duodenal Metastases of Lung Adenocarcinoma: Report of Two Cases and Review of Literature

Upper gastrointestinal bleeding as a result of gastrointestinal metastases from lung cancer is extremely rare. We report two cases of patients with duodenal metastases from lung adenocarcinoma presented with recurrent melena. Histopathological examination and immunohistochemical staining of the duodenal biopsies supported the diagnosis of metastatic lung adenocarcinoma.