Delayed Cutaneous Metastases of Mucus-Producing Cell Carcinoma of the Stomach

Abstract

A patient presented with an infiltrate resembling scleromyxoedema Arndt-Gottron which proved to be metastatic signet-ring cell carcinoma of the stomach. Later, round infiltrates appeared on the trunk. The primary lesion was excised 9 years previously and the cutaneous involvement was the sole manifestation of the process for more than a year. Most skin metastases of gastric carcinoma fall into three groups: generalized, by hematogenic dissemination; periumbilical; and those spreading by lymphatics to neck, head and upper thorax. The morphology may in some cases give a clue as to the histological composition of the infiltrate. In our case the scleromyxoedema-like morphology was due to production of mucus by the carcinoma.

Delayed Cutaneous Metastasis of Gastric Carcinoma

“…The long uneventful postoperative course until the development of the metastatic lesions appears to indicate that there were dormant tumor cells. Although delayed metastases have been described from time to time in breast cancer, malignant melanoma, neuroblastoma and renal cell carcinoma cases (1,2), those from gastric carcinoma are very rare (3)(4)(5)(6). In fact, only two cases of late metastasis of stomach cancer have appeared in the Japanese literature (5,6) despite the fact that stomach cancer is the leading cause of death from cancer in this country (11).…”

“…Delayed cutaneous metastase, which usually occurs more than nine to ten years after excision of the primary lesion, has been reported with several kinds of malignancies including breast cancer, malignant melanoma, and renal carcinoma (1,2). However, delayed metastasis of gastric cancer is extremely rare (3)(4)(5)(6). The mechanism of such a delayed metastasis is unclear, although this process must have a bearing upon the histologic features of the resultant lesions.…”