Early Gastric Cancer with Cellulitis-like Skin Metastasis

Abstract

Skin metastasis from internal carcinoma rarely occurs and it has an incidence of 0.7% to 9%. Although the prognosis of the skin metastases varies considerably depending on the type of the primary malignancy, presence of metastatic skin cancer usually implies a widespread systemic disease and a high mortality. A 50-year-old Korean male patient visited Dankook University Hospital for evaluation of skin rash on his whole abdomen of about 1 month's duration. He had undergone laparoscopy-assisted distal gastrectomy due to early gastric cancer about 3 months ago. He did not complain of any noticeable symptoms like febrile sense or pruritus. Skin biopsy was performed on the periumbilical area at previous port site and around the scar. Microscopic examination revealed multiple malignant cells in lymphatic spaces, consistent with metastatic carcinoma. He was therefore diagnosed with isolated skin metastasis from early gastric cancer. Because of patient's poor liver function, systemic chemotherapy could not be performed and only best supportive care was provided. Herein, we report a rare case of cellulitis-like skin metastasis from early gastric cancer with a brief review of the literature.

Aberrant metastatic behavior and particular features of early gastric cancer

“…The total rate of metastases is about 5–28% for regional lymph nodes and 0.14% for distant metastases . The most common sites of metastasis are the lymph nodes, liver, and peritoneum, but any organ including the bone, brain, lung, pleura, diaphragm, kidney, ovary, meninx, spleen, and thyroid can be involved . Regarding skin metastases, only one EGC with unusual periumbilical cellulitis‐like metastasis was reported in a 50‐year‐old Korean male, 3 months after laparoscopic gastrectomy .…”