Gastric Adenocarcinoma with Systemic Metastasis Involving the Intraocular Choroid and Duodenum

Gastric cancer with double metastasis to the orbit and duodenum is extremely rare. We report the case of a patient with gastric adenocarcinoma who presented with synchronous orbital and duodenal metastases at the time of initial diagnosis. A 60-year-old man presented with a 1-month history of visual disorder and pain in his right eye. He underwent ophthalmological examinations. The biopsy results suggested intraocular metastatic carcinoma. We conducted a systemic evaluation to identify primary malignancy. Finally, a diagnosis of advanced gastric adenocarcinoma with multi-organ metastasis was made. He planned to be treated with systemic chemotherapy.

Isolated Duodenal Metastasis of Hepatocellular Carcinoma: A Rare Presentation.

Hematogenous metastasis to the duodenum from any primary tumor is rare. Hepatocellular carcinoma (HCC) frequently metastasizes to lung and regional lymph nodes. Involvement of small intestines by HCC is mostly via direct invasion of the contiguous neoplasm. We report a case of isolated noncontiguous duodenal metastasis of HCC because of its rarity.

A Case of a Primitive Neuroectodermal Tumor Detected from a Duodenal Metastasis / 대한소화기내시경학회지

A primitive neuroectodermal tumor (PNET) belongs to the Ewing's sarcoma family and is a malignant small round cell tumor of neural crest origin. The most common site of an extraosseous Ewing's sarcoma is in the soft tissue of the body and extremities. A PNET in the ovary is uncommon. A PNET in the ovary is most often found with a metastasis and the prognosis is poor. The diagnosis of this tumor is confirmed following a pathohistological examination of tissue obtained after an open biopsy or surgery, but no case of a PNET has been diagnosed by the use of endoscopy in Korea. We present a case of a primitive neuroectodermal tumor of the ovary, which metastasized to the duodenum as diagnosed by use of an endoscopic biopsy in a 32-year-old woman who presented with abdominal discomfort.

A Case of Duodenal Metastasis from Adenocarcinoma of the Lung / 결핵및호흡기질환

A gastrointestinal metastasis from lung cancer is rare and is quite often found during an autopsy. A 58-year-old man was admitted with left upper back pain and a mass in the left upper lobe on the chest radiograph. The transbronchial lung biopsy revealed an adenocarcinoma of the lung. A gastroduodenoscopy was carried out to evaluate the indigestion and epigastric discomfort. The duodenofibroscopy revealed bulging mucosa on the minor papilla of the duodenum. A metastasis to the duodenum from an adenocarcinoma of the lung was diagnosed by a duodenofibroscopic biopsy of the bulging lesion. We report this rare case of an adenocarcinoma of lung with a metastasis to the duodenum.

Two Cases of Duodenal Metastasis from Lung Cancer with Obstructive Jaundice / 대한소화기내시경학회지

Lung cancer metastatic to the small intestine is uncommon. Despite the widespread nature of metastases that characterize this carcinoma, symptomatic intestinal metastases are extremely rare, but have been reported as a cause of intestinal obstruction, hemorrhage, malabsorption, and perforation. We have recently encountered two cases with squamous cell lung cancer who underwent endoscopic retrograde cholangiopancreatography for obstructive jaundice. Biopsies obtained from concentric ulcerative mass in the duodenum showed metastatic squamous cell carcinoma in the lymphatics. Histologically, the pulmonary and duodenal lesions were identical and this suggests a lymphatic route of dissemination. This is the report of two cases with obstructive jaundice secondary to duodenal metastasis from primary lung cancer. Metastatic squamous cell carcinoma of the lung to the duodenum should be considered in the differential diagnosis of patients harboring such a malignancy who have obstructive jaundice.

A Case of Laurence Moon-Bardet Biedl Syndrome with Chronic Renal Failure

Cytologic features of inflammatory pseudotumor of the lung have not been described frequently. We report fine needle aspiration cytologic(FNAC) finding of a case of inflammatory pseudotumor misdiagnosed as adenocarcinoma in a 63-year- old man. The FNAC displayed a mixture of histiocytes, myofibroblasts, pneumocytes, and plasma cells. Some histiocytes and myofibroblasts had large nuclei with irregular nuclear membrane and prominent nucleoli, which mislead the diagnosis of adeno- carcinoma on FNAC. The heterogeneous cell population is the unique cytologic features of inflammatory pseudotumor, which are helpful to distinguish it from other circumscribed benign and malignant lesions. Familiarity with these features is essential to avoid misdiagnosis and possible overtreatment.

A Case of Duodenal Metastasis of Hepatocellular Carcinoma Presenting Gastrointestinal Bleeding / 대한소화기내시경학회지

Extrahepatic metastasis of Hepatocellular carcinoma(HCC) to the gastrointestinal tract is uncommon. Because most of metastases to the gastrointestinal tract have no clinical manifestations, they are usually found incidentally at the time of an autopsy or a laparotomy, We experienced a case of duodenal metastasis of HCC, which presented UGI bleeding. A 59 years old male was admitted to our hospital due to generalized jaundice, which lasted for about a week. From the third day of admission, he had episodes of hematemesis and melena. An abdoinal CT scan demonstrated multiple, variable sized low-density masses in the entire liver with portal vein thrombosis and conglomerated lymph nodes. An esophagogastroduodenoscopy showed a protruded submucosal mass-like lesion with multiple ulceration in the duodenal bulb. We confirmed the duodenal mass-like lesion to be hepatocellular carcinoma by a biopsy and a histoimmunochemical study.