Abstract
In this case report, we will describe a gastric cancer case, which presented with rare manifestation of skin metastases and unrelated to the mechanical impact of distant metastases scleroderma-like paraneoplastic rheumatic syndrome.
 72-year-old woman was referred to hospital with complaints gradual during the time period of one year. Skin changes included - thickening, dermal induration mostly seen on her upper body – arms, neck, face, chest and abdominal wall, causing contracture and limited movements. In the area of her upper arms, neck and upper part of her chest multiple small, painless, hard subcutaneous nodules were present and hyperpigmentation in the neck area. There were no signs of Raynaud’s phenomenon, telangiectasia, alopecia, hypopigmentation or muscle weakness and pain. Upon further examination and multiple biopsies (gastric and skin nodules) poorly differentiated gastric carcinoma was confirmed with peritoneal dissemination, ascites, cutaneous, subcutaneous metastasis and scleroderma-like paraneoplastic syndrome. After systemic treatment for gastric cancer patient showed improvement of paraneoplastic syndrome manifestations, quality of life and radiologically stable disease.
Highlights
Gastric cancer can spread locally to adjuvant structures and develop distant metastatic deposits mainly by hematogenous spread
The incidence of cutaneous metastasis from carcinomas of the upper digestive tract has been reported to be less than 1%
Sister Mary Joseph's nodule, is the typical site for a cutaneous tumor resulting from metastasis of gastric cancer
Summary
Gastric cancer can spread locally to adjuvant structures and develop distant metastatic deposits mainly by hematogenous spread. Paraneoplastic syndromes are the expression of an underlying cancer, frequently occult, and can be caused by a wide variety of remote tumor effects unrelated to the mechanical impact of the tumor mass or distant metastases They result from substances released from tumor cells like hormones, peptides, antibodies, or from immunologic and other host reactions to the tumor [4]-[7]. In this case report, we will describe a gastric cancer case, which presented with skin metastases and unrelated to the mechanical impact of distant metastases scleroderma-like paraneoplastic rheumatic syndrome
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