Abstract
The present study aimed to investigate polypoid colonic metastases from gastric stump carcinoma by performing a retrospective analysis of the clinical data of a patient with such a diagnosis, and by discussing other previous case studies from the literature. The patient of the present study was an 80-year-old male who had undergone a gastrectomy 48 years previously for a benign perforated gastric ulcer. A colonoscopy revealed >10 multiple polypoid lesions of 6–10 mm in diameter distributed throughout the entire colon, except in the rectum. Each lesion had either erosion or a depression at the top and several were covered with a white fur-like substance. Biopsy specimens excised from the stomach showed a poorly-differentiated adenocarcinoma with diffuse signet ring cells, and a colonoscopy-guided biopsy revealed a signet ring cell adenocarcinoma. The patient was referred to the Oncology unit (Beijing Shijitan Hospital, Beijing, China) for assessment and chemotherapy treatment, which was initiated with 1,000 mg Xeloda orally administered twice a day for two-week courses every three weeks. The patient succumbed to upper gastrointestinal hemorrhage and pneumonia after three months. Gastric or gastric stump carcinoma may metastasize to the colon presenting as solitary or multiple colonic polyps. Thus, it is important to consider this diagnosis as such colon metastases may mimic solitary or multiple colonic polyps, which are commonly observed. A differential diagnosis is required in this complicated situation.
Highlights
The dissemination of gastric neoplasms commonly occurs due to hematogenous spread, lymphatic metastases, direct local invasion of adjacent organs and peritoneal or transcoelomic spread [1]
Gastric stump, carcinoma may metastasize to the colon and present as solitary or multiple colonic polyps, which is an extremely rare condition with
The present study reports a case of poorly‐differentiated adenocarcinoma with diffuse signet ring cells of gastric stump adenocarcinoma and mucosal metastases in multiple colonic polyps
Summary
The dissemination of gastric neoplasms commonly occurs due to hematogenous spread, lymphatic metastases, direct local invasion of adjacent organs and peritoneal or transcoelomic spread [1]. The primary tumor must be known and histologically confirmed. The possibility of direct local spread from the primary tumor must be excluded [3]. Colonic metastases from gastric adenocarcinoma usually present as ‘linitis plastica’ or as an annular stricture [5]. Gastric stump, carcinoma may metastasize to the colon and present as solitary or multiple colonic polyps, which is an extremely rare condition with
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