Wang Ying, Kong Guoqiang, Yuan Xiaozhi, Gao Shegan
Department of Oncology, The First Affiliated Hospital of Henan University of Science and Technology No. 24 Jinghua Road, Luoyang, Henan, China.
Int J Clin Exp Med. 2014 Mar 15;7(3):785-8. eCollection 2014.
A large proportion of gastric cardia adenocarcinoma (GCA) present initially in an advanced stage in China. Skin metastasis of primary GCA rarely occurs and the incidence of it is still unclear yet. Here we report one case of skin metastasis from GCA in a 58-year-old male patient who underwent gastric cardia resection in 2002 and did not undergo chemotherapy. However, he was diagnosed with anastomotic stoma adenocarcinoma by gastroscopy and histological biopsy in 2012.4. Then he underwent four cycles of "XELOX" regimen chemotherapy and the evaluation was PR. Upper gastrointestinal bleeding occurred and he was administered hemostatic therapy in 2012.9; meanwhile, he suffered from severe pains all over the body and received slow-release morphine. However, he was found to have dozens of cutaneous metastasizes in the skin of abdominal and back. Then, he underwent best supportive care and died of cachexia in 2013.5. GCA cutaneous metastasis indicates a highly invasive potential of tumors, poor chemo-radiotherapy efficacy and poor prognosis. The patient may survive just for another several months without the treatment of anti-tumor agents. Appropriate treatment may prolong patient survival.
在中国,很大一部分贲门腺癌(GCA)初诊时即处于晚期。原发性GCA的皮肤转移很少见,其发生率尚不清楚。在此,我们报告一例58岁男性患者的GCA皮肤转移病例,该患者于2002年接受了贲门切除术,未接受化疗。然而,2012年4月,他经胃镜检查和组织学活检被诊断为吻合口腺癌。随后他接受了四个周期的“XELOX”方案化疗,评估结果为部分缓解(PR)。2012年9月出现上消化道出血,给予止血治疗;同时,他全身剧痛,接受了缓释吗啡治疗。然而,发现他的腹部和背部皮肤有数十个皮肤转移灶。随后,他接受了最佳支持治疗,并于2013年5月死于恶病质。GCA皮肤转移表明肿瘤具有高度侵袭性、放化疗疗效差且预后不良。不使用抗肿瘤药物治疗,患者可能仅存活数月。适当的治疗可能延长患者生存期。