Gastric Metastasis from Colorectal Cancer Mimicking a Submucosal Tumor

Abstract

Signet-ring cell carcinoma, a colorectal cancer (CRC) subtype, sometimes shows metastases to uncommon metastatic sites. However, gastric metastasis is extremely rare. Here, we describe a case of gastric metastasis from colonic cancer. A 76-year-old woman presented with anemia. Colonoscopic biopsy revealed a CRC on the transverse colon showing a poorly differentiated adenocarcinoma with a partial component of the signet-ring carcinoma. Computed tomography revealed multiple subcutaneous nodules on her chest and back, and a tumor in the left lower lobe of her lung. Esophagogastroduodenoscopy showed a submucosal tumor-like lesion in the upper gastric body, and endoscopic biopsy revealed the poorly differentiated adenocarcinoma along with the partial component of the signet-ring carcinoma as well as the colonic, subcutaneous, and pulmonary lesion. The findings of endoscopic and microscopic examinations revealed gastric metastasis from CRC on the transverse colon. A systemic chemotherapy was given, and the biopsy conducted 1 year after the initial chemotherapy revealed

The Travels of Signet-Ring Cell Carcinoma: From Colon to Stomach and Duodenum

“…5 While gastric metastasis of CRC has been described, we identified only 1 case report that described the SRCC subtype extending from the colon to the stomach. 13 In this instance, esophagogastroduodenoscopy revealed a 2 cm submucosal lesion in the gastric body and lesser curvature with a smooth surface, central depression, and erosion. We also found 1 report where SRCC of the duodenum spread to the ovaries, peritoneum, and colon, and on endoscopy, there was an exophytic obstructing duodenal bulb mass.…”

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

“…There are cases in which signet ring cell adenocarcinoma of the mammary gland (46,47) and small-cell carcinoma of the lung present with metastases to the colon (48) with submucosal infiltration. In addition, cases in which signet ring cell adenocarcinoma of the sigmoid colon and rectum metastasized to the stomach (49,50), and poorly differentiated adenocarcinoma of the mammary gland metastasized to the stomach (51,52) with submucosal invasion have been reported. In many reports, --------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------ metastatic lesions from other organs that grow under the mucosa of organs of the gastrointestinal tract show polypoid or linitis plastica-like findings (46)(47)(48)(49)(50)(51)(52).…”

“…In addition, cases in which signet ring cell adenocarcinoma of the sigmoid colon and rectum metastasized to the stomach (49,50), and poorly differentiated adenocarcinoma of the mammary gland metastasized to the stomach (51,52) with submucosal invasion have been reported. In many reports, --------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------ metastatic lesions from other organs that grow under the mucosa of organs of the gastrointestinal tract show polypoid or linitis plastica-like findings (46)(47)(48)(49)(50)(51)(52). In general, metastases from other organs to the gastrointestinal tract are often hematogenous, are thought to infiltrate submucosal lymphatics, and develop as linitis plastica (16,53).…”

“…There are cases in which signet ring cell adenocarcinoma of the mammary gland ( 46 , 47 ) and small-cell carcinoma of the lung present with metastases to the colon ( 48 ) with submucosal infiltration. In addition, cases in which signet ring cell adenocarcinoma of the sigmoid colon and rectum metastasized to the stomach ( 49 , 50 ), and poorly differentiated adenocarcinoma of the mammary gland metastasized to the stomach ( 51 , 52 ) with submucosal invasion have been reported. In many reports, metastatic lesions from other organs that grow under the mucosa of organs of the gastrointestinal tract show polypoid or linitis plastica-like findings ( 46 – 52 ).…”

A Case of Gastric Metastasis Originating From right-sided Colon Cancer 4 Years After Colectomy

“…Gastric metastasis is exceptional with few cases reported in medical literature. Signet-ring cell carcinoma seems to be more likely responsible of metastases to uncommon sites in patients with CRC [ 1 ]. However, the pathogenesis of gastric metastasis from CRC remains unclear.…”