Abstract
Objective:To study the phenomena of complications of atypical distant lymphangitic metastasis by the example of gastric cancer.Methods:Within the framework of the study “Hereditary diffuse gastric cancer and measures for its prevention”, a clinical group and a control group of patients with the most likely risk of developing this genetic disease were recruited. DNA samples were taken from 119 patients of the main clinical group and the control group. In the course of filling out statistical charts, questioning and examination of patients, cases of distant lymphangitic and hematogenous metastasis were revealed in 7 patients. As diagnostic methods for distant lymphangitic and hematogenous metastasis, we used the results of studies of computed tomography, positron emission tomography combined with computed tomography of the whole body, nuclear magnetic resonance imaging, ultrasound methods, open biopsy and trephine-biopsy of lymph nodes.Results:Krukenberg’s tumors were detected in 2 patients, Virchow’s metastases - in 2 patients, metastases in the paraumbilical region - in 2 patients, Schnitzler metastases - in 1 patient, Irish node was detected in 1 of the examined patients. There was also a metastatic lesion of the lymph nodes of inguinal region on the left in 2 patients and one case of metastasis to the right testicle in a patient with true inguinal cryptorchidism. This article reflects one case of metastatic lesion of the inguinal nodes on the left and subsequent complications in the form of lymphostasis and pain syndrome.Conclusion:According to the classification of distant metastases in case of malignant neoplasms of the stomach, classical cases of metastases of Krukenberg, Virchow, Schnitzler, Sister Mary Joseph, and Irish were revealed. There is atypical metastasis to the inguinal nodes and to the undescended (true inguinal cryptorchidism) right testicle, which does not fall under the generally accepted classification of distant metastases of gastric cancer. Further tactics of treatment in the case of metastatic lesion to the inguinal regions in gastric cancer are not entirely clear, which requires an increase in the study of the amount of these clinical cases.
Highlights
Gastric cancer (GC) is the third largest mortality in the world
According to the practical recommendations for the medicinal treatment of gastric cancer, surgical removal of the primary tumor and/or metastasectomy in case of initially inoperable locally advanced or disseminated/metastatic GC is not recommended, because this procedure does not increase life expectancy
The lymph nodes of the inguinal-iliac regions on the left are unevenly enlarged with a size of 5.0 x 3.2 cm
Summary
Gastric cancer (GC) is the third largest mortality in the world. About 980 thousand people fall ill with gastric cancer in the world each year, while the mortality rate is 740 thousand people (according to WHO data from 2014).In our country, the incidence of stomach cancer ranks fourth after breast cancer, lung cancer and skin cancer. Gastric cancer (GC) is the third largest mortality in the world. About 980 thousand people fall ill with gastric cancer in the world each year, while the mortality rate is 740 thousand people (according to WHO data from 2014). The number of patients with gastric cancer in the Republic of Kazakhstan in 2017 is 2,737 people, with a death of 1,699 people. The mortality rate from gastric cancer in the Republic of Kazakhstan in 2017 is 9.5 cases per 100.0 thousand of population, the incidence rate is 15.3 cases per 100 thousand of population (according to the annual statistical materials “Indicators of the Oncological Service of the Republic of Kazakhstan”). As can be seen from statistics, the problem of gastric cancer for our country is very relevant. Diagnosis and prevention of gastric cancer are of great importance and require constant improvement according to the achievements of modern science and medicine
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