Open AccessMetastases from Gastric Carcinoma to Colon in the form of Multiple Flat Elevated Lesions: A Case Report
Author(s) -
Lee HsiChang,
Yang MinTa,
Lin KuangYang,
Tu HsingYang,
Zhang TingAn,
Chen PaoHuei
Publication year - 2004
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/s1607-551x(09)70257-8
Subject(s) - medicine , signet ring cell carcinoma , esophagogastroduodenoscopy , pathology , stomach , transverse colon , adenocarcinoma , malignancy , carcinoembryonic antigen , descending colon , carcinoma , colonoscopy , signet ring cell , curvatures of the stomach , lesion , cancer , radiology , colorectal cancer , gastroenterology , rectum , endoscopy
Gastric carcinoma is a common malignancy worldwide. Advanced stages of the disease may result in metastases to many other organs of the body. However, colonic metastases are rare. We report a case of gastric carcinoma with symptoms of abdominal fullness and weight loss. The serum carcinoembryonic antigen level was elevated. Esophagogastroduodenoscopy revealed giant folds occupying the whole gastric body and poor expansion of the stomach. Histologic examination of biopsy specimens from the giant fold demonstrated poorly differentiated adenocarcinoma with signet ring‐cell differentiation. Total colonoscopy revealed five or six discrete flat elevated lesions in the distal transverse, descending, and sigmoid colons. These lesions were characterized by a clear margin of 3‐5 mm in diameter and erosions on the tips. Polypectomy specimens demonstrated signet ring‐cell carcinoma, which was histologically similar to the specimens taken from the gastric lesion. We conclude that this was a rare case in which gastric signet ring‐cell carcinoma had metastasized to the colon in the form of flat elevated lesions, combined with rapid and wide lymphatic spread to the thorax and abdomen in a clinical course as short as 46 days.