Primary gastric squamous cell carcinoma (PGSCC) is an extremely rare cause of gastric malignancy.We present a 66-year-old man with a past medical history of stage I left palpebral marginal zone lymphoma status post radiation. The patient was complaining of a two-year history of bloating and early satiety. An upper endoscopy was performed, showing a 2.5 cm polypoid lesion at proximal corpus; however, the cardia and esophagus were normal. Biopsies were positive for gastric squamous cell carcinoma. He underwent partial gastrectomy and was referred to oncology for treatment.In 2011, the Japanese Gastric Cancer Association proposed diagnostic criteria for the diagnosis of PGSCC. The clinical presentation of this malignancy does not differentiate from that of other types of gastric tumors. We report this case to highlight squamous cell carcinoma as a cause of primary gastric cancer. Gastroenterologists should be aware of this entity to facilitate prompt referral to specialized centers, where surgical resection can be done.
Hepatic splenosis was first described in 1939 and is a rare condition that results from splenic trauma or splenectomy.A 43-year-old man with a past medical history significant for a prior splenectomy was admitted to the hospital due to right upper quadrant pain for two days. Magnetic resonance imaging (MRI) of the abdomen suggested features of hepatic adenoma, however, a percutaneous biopsy showed the mass within the liver to be a discrete collection of splenic tissue, apparently the result of a traumatic splenic rupture years ago.Hepatic splenosis is a rare entity, and due to the asymptomatic nature of this condition, most cases are found incidentally after different imaging modalities are done. The management of this entity is based on conservative measures. We report this case to emphasize that in the appropriate clinical setting, hepatic splenosis should be considered in the differential diagnosis of a patient with a homogenous well-circumscribed liver mass.
INTRODUCTION: Malignant neoplasms of the small bowel are rare, and mostly found as metastatic lesions from other neoplasms like lung cancer, renal cell carcinoma, breast cancer and melanomas. CRC is the 3rd cause of death associated to malignancies, and mostly metastasizes to liver, lung, and peritoneum. Duodenum as site of metastasis is rarely reported, reason why there is no specific prevalence of this entity and by 2017, there were less than cases reported in the literature. CASE DESCRIPTION/METHODS: We present a 52 yo man with a PMH of stage IIIB colon cancer s/p right hemicolectomy and chemotherapy, currently on remission. He had a recent normal colonoscopy 6 months prior this admission. The patient is admitted to the hospital complaining of abdominal discomfort, nausea, non-bloody vomiting, weight loss and melena for the past 2 weeks. His vital signs were stable. Laboratory results showed a hemoglobin of 6.6 g/dL and for this reason one pack of red blood cells was transfused. An EGD showed an ulcerated lesion on the duodenum (Figure 1). Biopsies were taken and these showed invasive, moderately differentiated adenocarcinoma. PET scan was done showing extensive metastatic liver and duodenal disease (Figure 2). The patient was referred to oncology for initiation of treatment with chemo and radiotherapy. DISCUSSION: Malignant tumors of the small intestine are very rare and involve only 1-2% of all gastrointestinal neoplasms. Metastasis from CRC has an unclear mechanism but is thought to be secondary to lymphatic spread or direct contact. Given its slow growth rate, duodenal tumors usually remain asymptomatic at onset. However, later in the course of the disease, the reported manifestations are melena, abdominal pain, and small bowel obstruction symptoms. Diagnosis is made through EGD and radiological studies. There is no stablished treatment, but surgery has been reported to be curative in some cases. Adjuvant chemotherapy can be used as a palliative option and survival rates have been reported to be 23% in 5 years. We report this case due to its rarity, since CRC tumors hardly metastasize to the duodenum. Furthermore, we would like to encourage expanding the research about treatment modalities, in order to improve prognosis in this entity.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.