Makker Jasbir, Karki Niraj, Sapkota Binita, Niazi Masooma, Remy Prospere
Division of Gastroenterology, Department of Medicine, Bronx Lebanon Hospital Center, Bronx, NY, USA.
Department of Medicine, Bronx Lebanon Hospital Center, Bronx, NY, USA.
Am J Case Rep. 2016 Aug 25;17:611-5. doi: 10.12659/ajcr.898534.
BACKGROUND Gastroesophageal cancers, previously considered rare, are rapidly increasing worldwide. We present here a unique case of gastroesophageal carcinoma with metastasis to the rectum. CASE REPORT A 60-year-old female patient presented with constipation, bloating, and weight loss of 4-month duration. She had undergone sleeve gastrectomy 6 years before. Endoscopies performed revealed a friable-looking mucosa in the lower esophagus and a polypoid rectal mass. Histopathological examination from both the esophageal and rectal lesions revealed poorly differentiated adenocarcinoma cells. Immunohistochemistry stain from both specimens was positive for CK7 supporting the gastric site primary with metastasis to the rectum. Further evaluation also revealed metastasis to bone and malignant pleural effusion. Chemotherapy with palliative intent was initiated. CONCLUSIONS Colorectal metastasis is commonly seen from cancers of the breast, stomach, melanoma, kidney, prostate, and ovaries. However, colorectal metastasis from gastroesophageal cancer has never been reported in the medical literature. Diagnosis relies on histopathologic examination and immunohistochemical staining of the tumor. Treatment depends on the tumor stage. Tumors with widespread metastatic disease are candidates for palliative chemotherapy.
背景 胃食管癌以往被认为较为罕见，但在全球范围内正迅速增加。我们在此报告一例独特的胃食管癌伴直肠转移病例。病例报告 一名60岁女性患者出现便秘、腹胀及持续4个月的体重减轻。她6年前接受了袖状胃切除术。内镜检查发现食管下段黏膜外观易碎，直肠有息肉样肿物。食管和直肠病变的组织病理学检查均显示为低分化腺癌细胞。两个标本的免疫组化染色CK7均为阳性，支持原发于胃且转移至直肠。进一步评估还发现骨转移和恶性胸腔积液。遂开始进行姑息性化疗。结论 结直肠转移常见于乳腺癌、胃癌、黑色素瘤、肾癌、前列腺癌和卵巢癌。然而，胃食管癌的结直肠转移在医学文献中从未有过报道。诊断依赖于肿瘤的组织病理学检查和免疫组化染色。治疗取决于肿瘤分期。广泛转移的肿瘤适合进行姑息性化疗。
