Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Department of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Clin J Gastroenterol. 2021 Aug;14(4):1014-1019. doi: 10.1007/s12328-021-01407-5. Epub 2021 May 24.
A 60-year-old man with autosomal dominant polycystic kidney disease presented with malaise, melena, and epigastric discomfort. Esophagogastroduodenoscopy revealed a massive elevated gastric cancer lesion involving the cardia. Histopathological evaluation of a biopsy specimen showed poorly differentiated adenocarcinoma. Fluorodeoxyglucose-positron emission tomography revealed significant fluorodeoxyglucose uptake in the stomach, liver, bones, and bone marrow. He was diagnosed with metastatic gastric cancer resistant to chemotherapy, and he developed bone marrow carcinomatosis and disseminated intravascular coagulation and died 8 weeks after disease onset. A statistically significant association is reported between autosomal dominant polycystic kidney disease and gastric cancer. Moreover, the specific clinical features observed in our patient could be attributed to the molecular disorders like PC-1 and mechanistic target of rapamycin that are known to occur in autosomal dominant polycystic kidney disease.
一位 60 岁的常染色体显性多囊肾病患者，因全身不适、黑便和上腹部不适就诊。食管胃十二指肠镜检查显示巨大的高位胃癌病变累及贲门。活检标本的组织病理学评估显示低分化腺癌。氟脱氧葡萄糖正电子发射断层扫描显示胃、肝、骨和骨髓中有明显的氟脱氧葡萄糖摄取。他被诊断为转移性胃癌，对化疗耐药，发生骨髓癌转移和弥漫性血管内凝血，发病 8 周后死亡。据报道，常染色体显性多囊肾病与胃癌之间存在显著的相关性。此外，我们观察到患者的具体临床特征可能归因于常染色体显性多囊肾病中已知发生的分子紊乱，如 PC-1 和雷帕霉素的作用靶点。
