Surgical case reports · 2025
Simultaneous Gastric Cancer Metastases to the Small and Large Intestines: Hidden Small Intestinal Lesions and Colonic-Mimicking Metastases.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nakamura Sota, Yamamoto Manabu, Nakamura Tsukasa, Tateishi Yuki, Sakada Ryo, Nagashima Shoichiro, Morita Kazutoyo, Higashi Hidefumi, Yoshizumi Tomoharu
Аннотация
INTRODUCTION: Gastric cancer often presents with metastases at diagnosis, but simultaneous metastases to both the small and large intestines are extremely rare and may be misinterpreted as synchronous primary intestinal cancers, particularly when preoperative imaging is inconclusive.
CASE PRESENTATION: A 78-year-old male receiving cabozantinib for hepatocellular carcinoma with vertebral metastasis presented with anorexia, epigastric discomfort, and melena. Endoscopy revealed an ulcerative gastric lesion, and colonoscopy showed irregular ulcerative lesions in the ascending and transverse colons. The patient underwent laparoscopic distal gastrectomy, right hemicolectomy. During surgery, a small intestinal tumor was suspected, prompting an additional partial resection. Histopathology and immunohistochemistry (CK7, CK20, CDX2, SATB2, Arginase-1) confirmed that the intestinal lesions were metastases from gastric cancer rather than synchronous primary colorectal cancers.
CONCLUSIONS: This case suggests that preoperative and intraoperative imaging may not detect rare metastatic patterns, and that immunohistochemical analysis may help estimate tumor origin. Careful differentiation between true synchronous colorectal cancer and gastric cancer with intestinal metastases may help guide treatment decisions.
CASE PRESENTATION: A 78-year-old male receiving cabozantinib for hepatocellular carcinoma with vertebral metastasis presented with anorexia, epigastric discomfort, and melena. Endoscopy revealed an ulcerative gastric lesion, and colonoscopy showed irregular ulcerative lesions in the ascending and transverse colons. The patient underwent laparoscopic distal gastrectomy, right hemicolectomy. During surgery, a small intestinal tumor was suspected, prompting an additional partial resection. Histopathology and immunohistochemistry (CK7, CK20, CDX2, SATB2, Arginase-1) confirmed that the intestinal lesions were metastases from gastric cancer rather than synchronous primary colorectal cancers.
CONCLUSIONS: This case suggests that preoperative and intraoperative imaging may not detect rare metastatic patterns, and that immunohistochemical analysis may help estimate tumor origin. Careful differentiation between true synchronous colorectal cancer and gastric cancer with intestinal metastases may help guide treatment decisions.