Multiple skeletal muscle metastases from poorly differentiated gastric adenocarcinoma.

Yuki Koga,Hideo Baba,Hironobu Shigaki,Junji Kurashige,Keisuke Kosumi,Yuji Miyamoto,Naoya Yoshida,Yasuo Sakamoto,Masaaki Iwatsuki,Yoshifumi Baba,Kazuto Harada,Takatsugu Ishimoto

doi:10.1186/s40792-015-0108-3

Yuki Koga, Hideo Baba + Show 10 more

Open Access

https://doi.org/10.1186/s40792-015-0108-3

Copy DOI

Journal: Surgical case reports	Publication Date: Oct 15, 2015
Citations: 28	License type: CC BY 4.0

Affiliation: Kumamoto University

Abstract

We report here a rare case of gastric carcinoma with multiple intramuscular metastases. A 71-year-old man presented with rapidly evolving swelling of his left thigh and severe pain. Three years earlier, he had undergone neoadjuvant chemotherapy followed by gastrectomy for advanced gastric cancer. A computed tomography scan showed unusual swellings in multiple skeletal muscles with no vessel or bone invasion. Importantly, the affected muscles did not contain distinct masses but were diffusely enlarged. Pathological examination of an open muscle biopsy showed a poorly differentiated adenocarcinoma, supporting a diagnosis of gastric cancer metastases in multiple skeletal muscles.

Highlights

Gastric cancer is the fourth commonest human malignant disease and the second commonest cause of cancer-related death worldwide [1]
We report here a case of a patient with swelling in the thigh that was diagnosed as skeletal muscle metastases from gastric carcinoma
Gastric cancer rarely metastasizes to skeletal muscle, and such metastases are generally associated with widespread metastatic disease and poor prognosis

Summary

Background

Gastric cancer is the fourth commonest human malignant disease and the second commonest cause of cancer-related death worldwide [1]. Even after curative resection, 50–60 % of patients relapse locally or with distant metastases. A Japanese study of 939 patients who had undergone surgery for gastric cancer found that recurrence was local in 22 % of cases, peritoneal in 43 %, hepatic in 33 %, and distant in 21 %; 25 % of patients had recurrences in multiple sites [2]. We report here a case of a patient with swelling in the thigh that was diagnosed as skeletal muscle metastases from gastric carcinoma. Case presentation A 71-year-old man presented with a rapidly evolving swelling of his left thigh and severe pain. The circumference of his left thigh was 56.7 cm and his right thigh was 36.8 cm (Fig. 1).

Discussion

Tougeron et al 2009 71 M Deltoid muscle

Findings

Conclusions