Metastases from Gastric Carcinoma to Colon in the form of Multiple Flat Elevated Lesions: A Case Report

Abstract

Gastric carcinoma is a common malignancy worldwide. Advanced stages of the disease may result in metastases to many other organs of the body. However, colonic metastases are rare. We report a case of gastric carcinoma with symptoms of abdominal fullness and weight loss. The serum carcinoembryonic antigen level was elevated. Esophagogastroduodenoscopy revealed giant folds occupying the whole gastric body and poor expansion of the stomach. Histologic examination of biopsy specimens from the giant fold demonstrated poorly differentiated adenocarcinoma with signet ring-cell differentiation. Total colonoscopy revealed five or six discrete flat elevated lesions in the distal transverse, descending, and sigmoid colons. These lesions were characterized by a clear margin of 3-5 mm in diameter and erosions on the tips. Polypectomy specimens demonstrated signet ring-cell carcinoma, which was histologically similar to the specimens taken from the gastric lesion. We conclude that this was a rare case in which gastric signet ring-cell carcinoma had metastasized to the colon in the form of flat elevated lesions, combined with rapid and wide lymphatic spread to the thorax and abdomen in a clinical course as short as 46 days.

Colonic metastasis of diffuse signet ring cells gastric carcinoma

“…The histological diffuse form (according to Lauren-Ming classification) with signet ring cells such as the one showing by our patient corresponds to the 3 to 39% of all gastric cancers (6), is known to affect young people with predominant blood group A, with no association with premalignant lesions, low relation to environmental factors, badly differentiated and displaying a higher lymphatic impairment (7). Colonic impairment is exceptional by haematological dissemination (8), as in the case we have described. We have found scarce references on this topic.…”

Colonic Metastasis From Gastric Cancer

“…10 There are reports of metachronous or synchronous colonic metastasis from primary gastric cancer. [11][12][13][14][15] Our patient presented with visible colonic mass but metastatic carcinoma usually preserves the mucosa and the positive yield from endoscopic biopsy is low (<50%). 15 It is not clear whether the metastatic colonic lesions are from direct extension of the initial primary gastric cancer or due to hematologic or lymphatic dissemination to the colon.…”

Metastatic squamous cell carcinoma of colon from esophageal cancer

“…Metastatic involvement of the colon is a rare occurrence and is extremely rare from primary extra-abdominal tumors. There are case reports of metastatic colon cancer from primary malignancy such as melanoma, SCC of the lung, gastric adenocarcinoma, and invasive ductal breast carcinoma [16–18]. To this date, there are three case reports from Asia published in English literature describing colonic metastasis from primary esophageal SCC [19–21].…”