Metachronous Rectum Metastases from Gastric Adenocarcinoma: A Case Report

Abstract

Introduction. Hepatic metastases of gastric adenocarcinomas are frequently observed due to the drainage into portal vein. Intestinal metastases disseminate from gastrocolic and mesenteric ligaments but they are seen very rarely and in most cases detected in postmortem studies. Case Report. A 74-year-old female patient with no known history of disease. Her complaints on application were epigastric pain, burning, and constipation. Gastroscopy showed a submucosal mass in the greater curvature of fundus and in colonoscopy, a mass with polypoid appearance that narrows the lumen at the rectum was detected. No far metastases or pathology were detected. Pathology report from gastric biopsy material demonstrated well-differentiated adenocarcinoma. Cytokeratin 7 (CK7) was found to be extensively strongly positive, Cytokeratin 20 (CK20) was negative in the immunohistochemical staining of the biopsy obtained from rectosigmoid area. Conclusion. Gastric cancer is among the frequent cancers today, most of which are adenocarcinomas. Although most of the metastases are observed in the liver, lungs, lymph nodes, and peritoneum, it should be remembered that intestinal metastases may be seen without the presence of any other metastatic focus. Our case is the first in literature reporting a rectum metastasis without any other organ metastasis.

Rectal resection for Schnitzler’s metastasis in a patient presenting with severe rectal stenosis: case report and review of the literature

“…In our patient, metacronous Schnitzler's metastasis occured 42 months after completion of treatment for gastric adenocarcinoma. In the reported cases, the median disease-free survival after gastrectomy was 38 months (range: 18-72 months) for metachronous metastases [5][6][7][8][9][10][11][12]. The disease-free survival of the present patient was 42 months.…”

“…Only ten cases, including the present case, have been reported in the English literature of Schnitzler's metastasis to the rectum [5][6][7][8][9][10][11][12][13]. The mean age of the reported patients was 58.2 years.…”

A rare case of colorectal metastasis found 8 years and 10 months after gastrectomy for advanced gastric cancer: A case report and literature review

“…To investigate the characteristics of colon metastasis from gastric cancer, we summarized the reported cases of gastric cancer colon metastasis. Synchronous colorectal metastases differ from metachronous; we found 24 metachronous (1-4,6,14-29) (Table I) and 13 synchronous cases (5,25,(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40), as classified and listed in Table II. Several reports have set the boundary between synchronous and metachronous metastases as diagnosed after 2 months, 6 months, and 1 year from the primary diagnosis.…”