Relationship between PET/CT metabolic parameters and pathological features and prognosis in ESCC patients with intramural gastric metastasis / 中国肿瘤生物治疗杂志

@#Objective: To investigate the relationship between PET/CT metabolic parameters and pathological features and prognosis in esophageal squamous cell carcinoma (ESCC) patients with intramural gastric metastasis (IGM). Methods: Totally 86 cases of ESCC IGM patients treated in Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2008 to December 2014 were selected for this study. The patients received the imaging examination by positron emission tomography and computed tomography (PET/CT). The metabolic parameters including maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), PET tumor length (PTL) and mean standard uptake value (SUVmean) were examined to calculate the total lesion glycolysis (TLG). The survival of the patients during 5-year follow-up was recorded, and the relationship between metabolic parameters and clinical pathological features and prognosis was analyzed. Results: SUVmax and SUVmean of IGM patients were related to the diameter of the primary tumor (all P<0.05); MTV was associated with the tumor diameter, lymph node metastasis, and TNM staging (all P<0.05); TLG was associated with the tumor diameter, lymph node metastasis, TNM stage, and tissue differentiation (all P<0.05). During the 5-year follow-up, 6 patients were lost to follow-up, 36 patients died and 44 patients survived; SUVmax, MTV, TLG, PTL, SUVmean, and TNM staging were predictors for patients’prognosis (all P<0.05); MTV, TLG, PTL, SUVmean, and TNM staging were risk factors for prognosis (all P< 0.05). Conclusion: The metabolic parameters including SUVmax, MTV, TLG, PTL and SUVmean in ESCC patients with IGM are related to the pathological characteristics of patients; moreover, MTV, TLG, PTL, SUVmean and TNM staging are risk factors for prognosis; so, PET/CT examination has certain clinical value for the prognosis assessment in ESCC patients with IGM.

Intramural gastric metastasis of esophageal squamous cell carcinoma: an analysis of imaging findings and clinicopathological features / 中华肿瘤杂志

Objective@#To discuss the imaging findings and clinicopathological features of the intramural gastric metastasis (IGM) of esophageal squamous cell carcinoma.@*Methods@#The imaging findings of 11 patients with IGM confirmed by surgical pathology were reviewed retrospectively, and compared with clinicopathological features. Of the 11 cases, eight underwent upper gastrointestinal radiography, ten underwent contrast enhanced computed tomography (CT) scans and one underwent plain CT scanning.@*Results@#In all 11 cases, the primary cancer was located in the middle or lower thoracic esophagus, and nine of 11 had lymph nodes metastasis. All of the 11 tumors within the stomach were located in the upper one-third of the stomach, with the maximum diameter of tumor ranging from 1.0 cm to 12.0 cm. Gastrointestinal radiography showed irregular filling defect of the stomach in three cases with clear border resembled a submucosal tumor. Mucosal folds of the stomach were irregular and rough in two cases. On CT scans, nodule or mass in the gastric wall was found in seven patients, and two of them were accompanied with ulcer formation. Eccentric or nodular gastric wall thickening was found in the other two patients. All of them were heterogeneous mild-to-moderate enhancement.@*Conclusions@#The imaging appearances of IGM have certain characteristics, but final diagnosis depends on histopathology. The prognosis of IGM was extremely poor, so the preoperative diagnosis is very important to guide clinical treatment.

A fatal gastric perforation secondary to ulcerated metastasis in undiagnosed breast cancer: pathological aspects and review of literature

The authors describe a fatal case of gastric perforation secondary to an ulcerated metastasis in a woman with undiagnosed breast cancer. The 48-year-old woman, with no significant medical history, presented with weight loss, persistent dyspepsia and pain in the epigastric and mesogastric region. She was treated by her primary care physician with proton-pump inhibitors and antispasmodics. The following day she was found dead at her home. External examination showed a tumefaction in the lateral region of her left breast, near the axilla. Autopsy revealed 1000 ml of turbid, light-brown peritoneal fluid in the abdominal cavity and a perforated gastric wall. Histological examination of the breast mass showed an infiltrating, poorly-differentiated breast carcinoma. Microscopical analysis of the stomach wall revealed a perforated metastatic gastric ulcer. Immunohistochemistry was required to confirm the neoplastic involvement of the stomach due to metastatic breast cancer.

Malignant Pleural Mesothelioma and Gastric Metastasis: A Very Rare Case Report and Literature Review.

Introduction: Malignant pleural mesothelioma (MPM) is a rare neoplasm. It has closed association with occupational asbestos exposure. Symptoms are commonly due to local invasion of pleura and mediastinal structures. MPM may have local or rarely distant organ metastasis by haematogenous spread in different organs such as liver, adrenal gland, kidney and contralateral lung. However, gastrointestinal involvement is very rare. Case Report: We report herein a 58-year-old female patient who was presented with back painand finally was diagnosed as MPM with distant metastasis to the stomach. Conclusion: Clinical, imaging and histopathologic findings play an important role in influencing the prognosis as well as treatment.

Improved Survival of a Patient with Gastric and Other Multiple Metastases from Ovarian Cancer by Multimodal Treatment: A Case Report

Gastric metastasis from ovarian carcinoma is extremely rare and the prognosis for patients is poor. We report a case of multimodal treatment improving the survival time of a patient with gastric metastasis from ovarian cancer. A 73-year-old woman with known serous ovarian cancer was admitted to the hospital due to epigastric pain and dyspepsia. On esophagogastroduodenoscopy, a protruding mass was noted at the gastric antrum. She underwent distal gastrectomy with Billroth I anastomosis and lymph node dissection, including the para-aortic lymph nodes. The final pathology revealed gastric metastasis from ovarian serous adenocarcinoma. In this case, after cytoreductive surgery, chemotherapy was performed each time a recurrence was diagnosed, and remission was accomplished. She survived for 108 months after the first diagnosis of the metastatic tumor in the stomach. Multimodal treatment of metastatic lesions since the first diagnosis allowed the patient to survive longer than those in previous reports.

Gastric Metastasis from Ovarian Adenocarcinoma Presenting as a Submucosal Tumor without Ulceration

Metastatic gastric cancer is extremely rare and gastric metastasis from ovarian adenocarcinoma has rarely been reported. All of the previously reported metastatic lesions presented as an ulcerative lesions. We report a case of 49-year-old woman in which gastric metastasis from ovarian adenocarcinoma presented as a submucosal tumor without ulceration on endoscopic examination. Gastrointestinal stromal tumor was suspected on endoscopic ultrasound (EUS) examination. It was confirmed histopathologically as metastatic ovarian adenocarcinoma after endoscopic submucosal dissection (ESD) with enucleation. Submucosal tumor of the stomach in patients with ovarian carcinoma should not be overlooked and ESD with enucleation may be a viable option when EUS with fine needle aspiration is not available.

Primary Epithelial Ovarian Carcinoma with Gastric Metastasis Mimic Gastrointestinal Stromal Tumor / Journal of the Korean Cancer Association, 대한암학회지

Epithelial ovarian carcinoma rarely metastasizes to the parenchyma of the stomach. A 55-years-old woman presented with epigastric pain and a feeling of fullness for one month. A subsequent contrast-enhanced CT scan demonstrated a 4.5 x 4 cm submucosal mass with focal ulceration in the gastric antrum, and this finding was suggestive of GIST. After gastric antrectomy, the final pathology showed metastatic gastric tumor from a primary ovarian serous carcinoma. Because epithelial ovarian carcinoma is usually spread along the peritoneal surface, stomach involvement is rare. Furthermore, transmural gastric metastasis is very rare in a patient with primary ovarian carcinoma. Until now, there has been no reported case of stomach involvement at presentation in a patient with primary ovarian carcinoma. We present here a case of ovarian carcinoma with gastric metastasis that mimicked GIST.

A Case of Esophageal Small Cell Carcinoma with Gastric Metastasis andwithout Regional Lymph Node Involvement / 대한소화기내시경학회지

Small cell carcinoma is most frequently described as occurring in the bronchial tree. Extrapulmonary small cell carcinoma is a very rare disease and it has been reported in the esophagus, stomach, small intestine, pancreas, uterus, salivary gland and prostate. Primary esophageal small cell carcinoma with gastric metastasis and without regional lymph node involvement is very rare. We have experienced a case of primary esophageal small cell carcinoma with gastric metastasis and without regional lymph node involvement. The patient was treated with chemotherapy and this patient is alive at 40 months after the treatment.

Metástasis gástricas de melanoma cutáneo: presentación de un caso clínico / Gastric metastasis of cutaneous melanoma

Presentamos el caso clínico de un paciente con carcinoma de primario desconocido en que se evidenció la presencia de múltiples melanomas cutáneos y gástricos. Se realiza una revisión de la literatura sobre melanoma y las metástasis gástricas.

A patient with clinical evidence of carcinoma of unknown primary site is reported. The study revealed the presence of multiple gastric and skin melanomas. A review of literature on melanoma and its gastric metastasis is presented

A case of stomach metastasis from breast cancer / 대한내과학회지

Metastatic cancer from breast cancer is not uncommon and it often involves multiple organs. Gastric metastasis from breast cancer is much rarer than lung, bone and lymph node metastasis. Most of the symptoms are nonspecific, so it is not easy to differentiate primary gastric cancer from gastric metastasis from the breast. In particular, gastric and breast cancers are the two most common cancers among Korean women, so efforts should be made to distinguish primary gastric cancer from gastric metastasis because treatment and prognosis are very different between two. A few cases have been reported in Korea concerning gastric metastasis from breast cancer. We report here a case of gastric metastasis from infiltrating duct carcinoma of the breast.

A Case of Gastric Metastasis of Breast Carcinoma Resembling Early Gastric Cancer / 대한소화기학회지

Many patients suffering from breast carcinoma have metastases at initial diagnosis. The common metastatic sites are skeleton, liver and lung. Metastases to stomach are rare and only three cases have been reported in Korea. The endoscopic features of gastric metastases from breast carcinoma can be divided into three main categories: diffuse infiltration, external compression, and localized tumor deposition with ulceration or with a polypoid mass. However, metastatic gastric lesions which resemble early gastric carcinoma are rare. Typically, gastric metastases are confined to submucosa and muscularis, so that mucosal biopsy specimens might be false-negative. We report a case of gastric metastasis from infiltrative lobular carcinoma of the breast in a 66-year-old woman who had undergone left mastectomy with postoperative radiotherapy 17 years earlier. Initial diagnosis was early gastric carcinoma, signet ring cell type on gastric biopsy findings. However, definitive diagnosis of metastatic breast cancer was confirmed after endoscopic mucosal resection of a presumed primary early gastric carcinoma.

A Case of Primary Esophageal Small Cell Carcinoma with Gastric Metastasis / 대한소화기내시경학회지

Gastric metastasis of malignant tumors is relatively rare but has been reported in cases of malignant melanoma, lung cancer, breast cancer and squamous cell carcinoma of the esophagus. Primary small cell carcinoma of the esophagus is very rare and is an extremely aggressive tumor. Regional lymph node involvement, and distant metastasis to other organs including liver, bone, skin, lung, bone marrow, and brain are common at the time of initial diagnosis. To date, there has been no case reported of gastric metastasis from primary esophageal small cell carcinoma. A 72-year-old man presented with dysphagia for 2 months. An esophagogastroduodenoscopy revealed esophageal carcinoma with a submucosal tumor in the upper body of the stomach. Pathologic examination revealed an esophageal small cell carcinoma, and gastric submucosal infiltration of the small cell carcinoma was noted. We report a case of primary esophageal small cell carcinoma with submucosal tumor like gastric metastasis.

Two Cases of Endoscopically Diagnosed Gastric Metastatic Malignant Melanoma of Unknown Origin / 대한소화기내시경학회지

Although malignant melanoma involving the stomach is commonly mentioned in association with autopsies, endoscopic experience in this gastric malignancy is still limited, and few cases have been illustrated in the literature. This clinical condition is even rarer in Asians who are much less vulnerable to malignant melanoma than Caucasians. We experienced two cases of gastric metastases of malignant melanoma which presented as indigestion and epigastric pain. In the first case, a 75-year-old man visited because of indigestion persisting for 2 months. He had a history of multiple gastric ulcer and was treated at a local medical center, but symptoms did not improved. Endoscopic finding revealed multiple and elevated lesions with central black pigmented bases. In the second case, a 47-year-old man visited because of epigastric soreness and intermittent pain for 1 month. Metastatic melanoma in the stomach was noticed by endoscopic examination. Both patients had multiple metastatic lesions in the liver, thyroid, and brain. These two cases were diagnosed as having metastatic malignant melanoma in the stomach of unknown origin. Therefore, we report these cases with a brief review of the related literature.

A Case of Gastric Metastasis from Breast Carcinoma Manifested by Upper Gastrointestinal Bleeding / 대한소화기내시경학회지

Breast carcinoma is common malignancy in women and frequently metastasize to multiple organ such as lung, bone, lymph node and liver. But metastasis to gastrointestinal tract is rare and only two cases have been reported in Korea. We experienced a case of upper gastrointestinal bleeding caused by gastric metastasis from ductal carcinoma of breast and report this case with review of several literatures.

A Case of Gastric Metastasis of Malignant Melanoma Diagnosed by Gastroscopy / 대한소화기내시경학회지

Gastric metastasis occurs in about 0.7% to 1.7%, of patients dying of solid tumors of extragastrointestinal origin. Metastatic disease involving the stomach is an unusual and difficult clinical problem and presenting symptoms include nonspecific epigastric pain and melena. In most cases of gastric metastasis, the histologic finding of the gastroscopic biopsy suggests the correct diagnosis. There are only a few reports of gastric metastasis from malignant melanoma. We report a case of malignat melanoma of gastric metastasis, which was diagnosed by gastroscopy.

A Case of Gastric Metastasis of Malignant Melanoma Diagnosed by Gastroscopy / 대한소화기내시경학회지

Gastric metastasis occurs in about 0.7% to 1.7%, of patients dying of solid tumors of extragastrointestinal origin. Metastatic disease involving the stomach is an unusual and difficult clinical problem and presenting symptoms include nonspecific epigastric pain and melena. In most cases of gastric metastasis, the histologic finding of the gastroscopic biopsy suggests the correct diagnosis. There are only a few reports of gastric metastasis from malignant melanoma. We report a case of malignat melanoma of gastric metastasis, which was diagnosed by gastroscopy.