Lee Woo Yong, Lee Hye Kyeon
Department of Surgery, Seoul Paik Hospital, Inje University College of Medicine, 9, Mareunnae-ro, Jung-gu, Seoul 100-032, Republic of Korea.
Department of Pathology, Seoul Paik Hospital, Inje University College of Medicine, 9, Mareunnae-ro, Jung-gu, Seoul 100-032, Republic of Korea.
Int J Surg Case Rep. 2020;71:172-175. doi: 10.1016/j.ijscr.2020.05.009. Epub 2020 May 19.
Metastatic intraluminal cancer arising from gastrointestinal tract cancer is very rare. In this report, we describe a case of an 82-year-old man with sequentially metastatic gastric and jejunal cancer originating from primary colon cancer.
An 82-year-old Korean male patient with a history of right colon cancer was initially treated with extended right hemicolectomy. The tumour was classified as pT3N0M0 and stage II. After nine months, a gastroscopy revealed an infiltrating ulcerative mass in the cardia of the stomach, a colonoscopy revealed no specific findings in the previous operation site, and a positron emission tomography-computed tomography scan revealed no distant metastasis. The patient underwent radical total gastrectomy, and the final pathologic diagnosis was T3N2M0, stage IIIA. During follow-up without chemotherapy, a gastroscopy revealed tumours in the blind jejunal loop of Roux-en-Y anastomosis, and an endoscopic biopsy confirmed adenocarcinoma. The patient then underwent segmental resection of the blind loop jejunal cancer. Finally, further pathological examination of the resected specimen confirmed that the lesion represented a sequentially metastatic gastric and jejunal cancer originating from colon cancer.
The exact mechanism of intraluminal metastasis of gastrointestinal tract cancer is not known. Immunohistochemical staining might prove useful in sequentially metastatic cases when a differential diagnosis must be assessed on consecutive biopsies.
Although intraluminal metastasis of gastrointestinal tract cancer is very rare, researchers should be aware of this uncommon intraluminal metastasis.
胃肠道癌引起的转移性腔内癌非常罕见。在本报告中，我们描述了一例82岁男性患者，其原发性结肠癌先后转移至胃和空肠。
一名82岁的韩国男性患者，有右结肠癌病史，最初接受了扩大右半结肠切除术。肿瘤分类为pT3N0M0，II期。九个月后，胃镜检查发现胃贲门处有浸润性溃疡性肿块，结肠镜检查在前次手术部位未发现特异性病变，正电子发射断层扫描-计算机断层扫描未发现远处转移。患者接受了根治性全胃切除术，最终病理诊断为T3N2M0，IIIA期。在未进行化疗的随访期间，胃镜检查发现Roux-en-Y吻合术的空肠盲袢有肿瘤，内镜活检证实为腺癌。患者随后接受了空肠盲袢癌的节段性切除。最后，对切除标本的进一步病理检查证实，该病变为原发性结肠癌先后转移至胃和空肠。
胃肠道癌腔内转移的确切机制尚不清楚。在必须对连续活检进行鉴别诊断的相继转移病例中，免疫组织化学染色可能有用。
尽管胃肠道癌的腔内转移非常罕见，但研究人员应意识到这种不常见的腔内转移。
