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胃腺癌R0切除术后手术瘢痕处的腹壁转移:一个不寻常的部位(病例报告)

Abdominal parietal metastasis on operative scar of gastric adenocarcinoma after R0 resection: An unusual location (about a case).

作者信息

Ahue Kouassi Henry Noel, Keita Moctar, Goho Kouide Marius, N'Guessan Saint-Blanc Yapo Israel, Adon Auguste Alexandre, Coulibaly N'Golo Adama

机构信息

Felix Houphouët-Boigny University, Abidjan, Ivory Coast; Department of General, Digestive and Endocrine Surgery, Treichville Hospital and University Center, Abidjan, Ivory Coast.

Felix Houphouët-Boigny University, Abidjan, Ivory Coast; Surgical Emergency Department of the Treichville Hospital and University Center, Abidjan, Ivory Coast.

出版信息

Int J Surg Case Rep. 2024 Dec;125:110598. doi: 10.1016/j.ijscr.2024.110598. Epub 2024 Nov 14.

Abstract

INTRODUCTION

Gastric cancer is the fifth most common cancer in Ivory Coast, and is the third cause of cancer death. Parietal metastasis is extremely rare and are distinguished by their relatively poor prognosis with a median survival not exceeding 7 months.

OBSERVATION

We report the case of a 73-year-old male patient who presented 5 months after a partial R0 lower polar gastrectomy for gastric adenocarcinoma, a single cutaneous metastasis at the level of the laparotomy incision. The histology of this metastasis was an adenocarcinoma. Multidisciplinary consultation meeting, palliative chemotherapy and metastasis surgery was proposed but with the rapid progression of the tumor disease the patient died 3 months after the diagnosis of the metastasis.

DISCUSSION

Gastric cancer is the fifth most common cancer in Ivory Coast, and is the third cause of cancer death. The most common metastases in patients are the liver, peritoneum and lungs. Parietal metastasis are rare and their frequency is estimated at 4 % in visceral cancers. Anterior abdominal wall metastases have mainly been associated with surgical incision, whether by laparotomy or laparoscopy. Clinical representation is often in the form of dermal or hypodermal nodules of variable size and generally limited number, rapid growth. The diagnosis is made either by carrying out a biopsy or by anatomopathological examination of the surgical specimen. The management is palliative. The prognosis for parietal metastasis is often poor.

CONCLUSION

Parietal metastasis has a poor prognosis and should always be considered in the face of skin lesions in patients with a history of cancer.

摘要

引言

胃癌是科特迪瓦第五大常见癌症,也是癌症死亡的第三大原因。壁层转移极为罕见,其预后相对较差,中位生存期不超过7个月。

病例报告

我们报告一例73岁男性患者,在因胃腺癌接受R0根治性低位部分胃切除术后5个月,在剖腹手术切口处出现单个皮肤转移瘤。该转移瘤的组织学检查为腺癌。建议进行多学科会诊、姑息化疗和转移瘤手术,但由于肿瘤疾病进展迅速,患者在转移瘤诊断后3个月死亡。

讨论

胃癌是科特迪瓦第五大常见癌症,也是癌症死亡的第三大原因。患者最常见的转移部位是肝脏、腹膜和肺部。壁层转移罕见,在内脏癌症中的发生率估计为4%。前腹壁转移主要与手术切口有关,无论是剖腹手术还是腹腔镜手术。临床表现通常为大小不一、数量一般有限且生长迅速的真皮或皮下结节。诊断通过活检或手术标本的病理检查进行。治疗为姑息性治疗。壁层转移的预后通常较差。

结论

壁层转移预后不良,对于有癌症病史的患者出现皮肤病变时应始终予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7f8/11621794/93cb8fab05df/gr1.jpg

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