Division of Gastroenterology, Tohoku University Hospital, 1-1 Seiryo-Cho Aoba-Ku, Sendai, Miyagi, 980-8574, Japan.
Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Clin J Gastroenterol. 2020 Dec;13(6):1062-1065. doi: 10.1007/s12328-020-01191-8. Epub 2020 Jul 25.
Gastric squamous-cell carcinoma (SqCC) metastasized form the cervix is rarely detected in endoscopic examination, although cervical carcinoma is the second most common in gynecologic malignancy. A 59-year-old female visited a clinic for anorexia, and an esophago-gastro-duodenoscopy (EGD) revealed multiple submucosal tumors (SMTs) of the stomach. After she was referred, an image-enhanced endoscopy enhanced multiple SMTs with white spots, whose findings were irregular micro-vascular patterns in the mucosa with irregular/absent micro-surface pattern. We took endoscopic biopsies, whose histological diagnoses were SqCC in the layer of the lamina propria under normal epithelium. Positron emission tomography-CT, CT and magnetic resonance imaging revealed an irregularly enhanced mass of the cervix, the irregularly thickening wall of the stomach and peritoneal nodules. Palliative care alone was administered based on poor condition associated with the Stage IV cervical carcinoma. In this case, endoscopic detection of gastric SqCC might provide a tip to make final diagnosis of primary site of cervical SqCC. The numbers of endoscopic examination become increasing, so further deep awareness of such patterns of metastasis in cervical cancer are required.
胃鳞状细胞癌(SqCC)从宫颈转移的形式很少在内镜检查中被发现,尽管宫颈癌是妇科恶性肿瘤中第二常见的。一位 59 岁女性因厌食症到诊所就诊,食管胃十二指肠镜(EGD)显示胃内有多个黏膜下肿瘤(SMT)。她被转介后,增强内镜增强显示多个 SMT 有白点,其发现是黏膜不规则微血管模式伴有不规则/缺失的微表面模式。我们进行了内镜活检,组织学诊断为正常上皮下固有层的 SqCC。正电子发射断层扫描 - CT、CT 和磁共振成像显示宫颈不规则增强肿块、胃壁不规则增厚和腹膜结节。由于与 IV 期宫颈癌相关的不良状况,仅给予姑息性治疗。在这种情况下,胃 SqCC 的内镜检测可能提供线索,有助于对宫颈 SqCC 的原发部位做出最终诊断。内镜检查的数量越来越多,因此需要进一步加深对宫颈癌转移这种模式的认识。