Colonic anastomosis and colonic polyp mucosal metastasis of signet ring cell gastric adenocarcinoma

Salas, Nuria Rodríguez; Paz, Carmen; Rivera, Teresa; Alfonso, Ana; Marino, A. Martin; Álvarez, María Luz Alonso

doi:10.1007/s12094-010-0496-6

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…One such case occurred 11 years after a total gastrectomy for a poorly-differentiated adenocarcinoma of the stomach (4). A second case occurred at the colonic anastomosis, with colonic polyp mucosal metastasis of a signet ring cell gastric adenocarcinoma developing one year after a sigmoidectomy with termino-terminal anastomosis for sigmoid adenocarcinoma (2). Two cases presented with colonic metastasis at the time of the diagnosis of gastric cancer; however, yet another case was recorded by postmortem investigation (6,10–12).…”

Section: Discussionmentioning

confidence: 99%

“…The colonic lesions were multifocal, therefore the actual colonic lesions corresponded with the mucosal spread of the primary gastric cancer. A previous study has hypothesized that tissues of chronic inflammation may provide a spectrum of mitogen and trophic signals that make this area more favorable for the establishment of tumor metastasis (2). However, the routes by which lymphatic or hematogenous metastases occur could not be excluded in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Metastases are found at the sites of the regional lymph nodes, peritoneum, liver, lungs and bones (2). The criteria for the diagnosis of metastatic tumors are well documented.…”

Section: Introductionmentioning

confidence: 99%

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Polypoid colonic metastases from gastric stump carcinoma: A case report

et al. 2014

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The present study aimed to investigate polypoid colonic metastases from gastric stump carcinoma by performing a retrospective analysis of the clinical data of a patient with such a diagnosis, and by discussing other previous case studies from the literature. The patient of the present study was an 80-year-old male who had undergone a gastrectomy 48 years previously for a benign perforated gastric ulcer. A colonoscopy revealed >10 multiple polypoid lesions of 6–10 mm in diameter distributed throughout the entire colon, except in the rectum. Each lesion had either erosion or a depression at the top and several were covered with a white fur-like substance. Biopsy specimens excised from the stomach showed a poorly-differentiated adenocarcinoma with diffuse signet ring cells, and a colonoscopy-guided biopsy revealed a signet ring cell adenocarcinoma. The patient was referred to the Oncology unit (Beijing Shijitan Hospital, Beijing, China) for assessment and chemotherapy treatment, which was initiated with 1,000 mg Xeloda orally administered twice a day for two-week courses every three weeks. The patient succumbed to upper gastrointestinal hemorrhage and pneumonia after three months. Gastric or gastric stump carcinoma may metastasize to the colon presenting as solitary or multiple colonic polyps. Thus, it is important to consider this diagnosis as such colon metastases may mimic solitary or multiple colonic polyps, which are commonly observed. A differential diagnosis is required in this complicated situation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Polypoid colonic metastases from gastric stump carcinoma: A case report

et al. 2014

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“…As the colonic polypoid metastases implied the wide spread of the disease, most of the previous cases were treated with a non-operative approach using systemic chemotherapy [ 1 , 5 , 6 ] or best supportive care [ 7 ], and the outcomes were diverse and poor.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple polypoid colonic metastases from other distant gastrointestinal carcinomas are extremely rare, only a few cases have been reported in the literatures [ 1 – 7 ]. Among these cases, colonic metastases were mainly originated from gastric carcinoma or melanoma, with signet ring cell features being the most common histological type.…”

Section: Introductionmentioning

confidence: 99%

Multiple polypoid colonic metastases from rectal adenocarcinoma with signet ring cells features: a case report

Zhou

Liu

et al. 2020

BMC Gastroenterol

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Background Multiple polypoid colonic metastases are very rare which mainly originated from gastric carcinoma or melanoma. For rectal cancers, liver, lung and peritoneum are the most common metastatic sites. Here we present an unusual case with rectal adenocarcinoma and metachronous multiple colonic polypoid metastases. Case presentation A 53-year-old man who underwent radical resection for rectal cancer 2 years ago was admitted to our department for an elevation of CEA level of 18.4 ng/ml. Colonoscopy revealed ten ivory rubbery colonic polypoid lesions (about 5 mm in diameters) in the large bowel which were confirmed as signet ring cell carcinomas (SRCC) by biopsy, but full-body contrast enhanced CT and PET-CT showed no other suspicious lesion. Seven weeks later, a laparoscopic total colectomy was performed and more than 50 polypoid lesions were observed throughout the mucosal surface of the large intestine which were confirmed as metastatic SRCC by postoperative pathological examination. All the 34 paracolic lymph nodes retrieved were involved. After 4 months, diffuse abdominopelvic and multiple bone metastases were identified by CT and the patient died of the disease 1 month later. Conclusion Here we present an unusual case of multiple colonic polypoid metastases of rectal adenocarcinoma. For SRCC that is prone to have disseminated micrometastases, colonic ‘polyps’ may be the early noticeable sign of undetectable and extensive tumor spread. Instead of surgical resection of ‘the confined disease in colon’, systemic treatment maybe a more appropriate choice.

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