John Sharon, Cantu Lopez Carlos, Herrera-Gonzalez Sarahi, Bains Yatinder
Internal Medicine, St. George's University School of Medicine, St. George's, GRD.
Internal Medicine, Saint Michael's Medical Center, Newark, USA.
Cureus. 2024 May 1;16(5):e59483. doi: 10.7759/cureus.59483. eCollection 2024 May.
Metastasis of gastric carcinoma to atypical locations can complicate management, often leading clinicians to rely heavily on chemotherapy. While instances of gastric carcinoma spreading to the liver, peritoneum, and lymphatics are well documented in the literature, there is limited evidence of its spread to intraintestinal organs, particularly the colon. This scarcity of reports complicates diagnosis, given the variations in histopathology. This case report highlights a 35-year-old patient diagnosed with colonic metastasis from hereditary diffuse gastric cancer (HDGC) while being evaluated for potential causes of iron deficiency anemia. A mutation in the E-cadherin (CDH1) tumor suppressor gene is associated with HDGC. Dysregulation of CDH1 leads to tumor proliferation, invasion, migration, and metastasis. Treatment options for gastric cancer include surgical resection with neoadjuvant or adjuvant chemotherapy or palliative care with chemotherapy in metastatic disease. Although colonic metastasis from gastric cancer is rare, documented incidents can offer valuable insights that avoid misdiagnosing primary tumors and help guide further management.
胃癌转移至非典型部位会使治疗变得复杂，常常导致临床医生严重依赖化疗。虽然文献中已有充分记载胃癌扩散至肝脏、腹膜和淋巴管的病例，但关于其扩散至肠内器官尤其是结肠的证据有限。鉴于组织病理学存在差异，此类报告的稀缺使得诊断变得复杂。本病例报告重点介绍了一名35岁患者，在评估缺铁性贫血的潜在病因时，被诊断为遗传性弥漫性胃癌（HDGC）的结肠转移。E-钙黏蛋白（CDH1）肿瘤抑制基因的突变与HDGC相关。CDH1的失调会导致肿瘤增殖、侵袭、迁移和转移。胃癌的治疗选择包括新辅助或辅助化疗的手术切除，或转移性疾病的化疗姑息治疗。虽然胃癌的结肠转移很少见，但已记录的病例可以提供有价值的见解，避免对原发性肿瘤的误诊，并有助于指导进一步的治疗。
