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印戒细胞胃癌的皮肤转移:一例报告

Cutaneous Metastases of Signet-Ring Cell Gastric Carcinoma: A Case Report.

作者信息

Kurmus Gökçe Isil, Canpolat Filiz, Gönül Müzeyyen, Gökçe Aysun, Kartal Selda Pelin

机构信息

Ankara Etlik City Hospital, Department of Dermatology and Venereology, Ankara, Turkey.

Ankara Etlik City Hospital, Department of Pathology, Ankara, Turkey.

出版信息

Curr Health Sci J. 2024 Jul-Sep;50(3):444-447. doi: 10.12865/CHSJ.50.03.12. Epub 2024 Sep 30.

Abstract

The cutaneous metastases from carcinoma of the stomach are rare and either an index of a silent visceral neoplasm or a recurrence of an already diagnosed malignancy. They usually present as asymptomatic nodules or plaques; thus, they can be mistaken for other skin conditions, which leads to a potential misdiagnosis. The definition of signet-ring cell (SRC) gastric carcinoma is that it can easily cause a diffusion enbloc through lymphatic and hematogenous pathways, inducing skin manifestations such as indurated plaques, nodules, and erysipelas-like lesions. The infrequency of skin metastasis from gastric carcinoma underlines once more the need for increased awareness on the part of clinicians. Diagnosis, histopathological examination, and immunohistochemistry are essential. The confirmation of SRC tumors is done by staining for mucin, such as periodic acid-Schiff (PAS) and mucicarmine, and by using immunohistochemical markers like CK7. Almost always, cutaneous metastasis from SRC gastric carcinoma has a poor prognosis since these tumors are highly aggressive and chemotherapy-resistant. We present a case of cutaneous metastasis from SRC gastric carcinoma, a subtype of gastric cancer with a well-documented tendency both for distant and cutaneous spread. Generally, skin metastases from SRC gastric carcinoma are associated with poor prognosis, rapid progression of the disease, and a high mortality rate. This case underlines the need for early detection and a multidisciplinary approach by dermatologists, oncologists, and surgeons to improve outcomes in such patients.

摘要

胃癌的皮肤转移罕见,要么提示存在隐匿的内脏肿瘤,要么是已确诊恶性肿瘤的复发。它们通常表现为无症状的结节或斑块;因此,可能会被误诊为其他皮肤疾病。印戒细胞(SRC)胃癌的特点是容易通过淋巴和血行途径发生整块扩散,引发如硬结性斑块、结节及丹毒样损害等皮肤表现。胃癌皮肤转移的罕见性再次凸显了临床医生提高认识的必要性。诊断、组织病理学检查及免疫组化至关重要。SRC肿瘤的确诊通过黏液染色,如过碘酸希夫(PAS)染色和黏液卡红染色,以及使用免疫组化标志物如CK7来完成。几乎所有情况下,SRC胃癌的皮肤转移预后都很差,因为这些肿瘤具有高度侵袭性且对化疗耐药。我们报告一例SRC胃癌皮肤转移病例,SRC胃癌是胃癌的一种亚型,其远处及皮肤转移倾向已有充分记录。一般来说,SRC胃癌的皮肤转移预后差、疾病进展快且死亡率高。该病例强调了皮肤科医生、肿瘤内科医生和外科医生早期发现及采取多学科方法以改善此类患者预后的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c629/11578364/c8cb73969c67/CHSJ-50-03-444-fig1.jpg

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