Terakawa Hirofumi, Oyama Katsunobu, Watanabe Toshifumi, Tsukada Tomoya, Okamoto Koichi, Kinoshita Jun, Furukawa Hiroyuki, Makino Isamu, Nakamura Keishi, Hayashi Hironori, Inokuchi Masafumi, Nakagawara Hisatoshi, Miyashita Tomoharu, Tajima Hidehiro, Takamura Hiroyuki, Ninomiya Itasu, Kitagawa Hirohisa, Fushida Sachio, Fujimura Takashi, Ohta Tetsuo
Dept. of Gastroenterologic Surgery, Kanazawa University.
Gan To Kagaku Ryoho. 2014 May;41(5):645-8.
A 59-year-old man with gastric cancer underwent a total gastrectomy with splenectomy and D2 lymph node dissection. Pathological findings after the first operation were as follows: ML, AntLess, type 3, por, pT3, ly1, v0, and M, Post, 0-II c, tub1, pT1b2, ly0, v0, pN2M0P0H0, pStage IIIA. At 3 years and 6 months after the operation, multiple small nodules were noted on the skin of his face, neck, body, and arms. Biopsy of a skin lesion indicated that it was a metastatic skin cancer resulting from an adenocarcinoma. Thus, we diagnosed the lesions as skin metastases originating from an adenocarcinoma of the stomach. We also detected the presence of multiple metastases to the bone and lymph nodes, and we have treated the patient with chemotherapy. Metastases to the umbilicus from gastric cancer are termed as Sister Mary Joseph's nodules (SMJN). Although cases of SMJN are often reported, cases of multiple metastases from gastric cancer, without invasion to the umbilicus, are rare.
