Primary Gastric Carcinoma Research Articles

Gastric cancer with breast metastasis: Clinical features and prognostic factors.

Metastatic spread of gastric carcinoma to the breast is rare. In previous decades, reports on this subject were minimal and primarily limited to case reports. At present, little is known on the clinicopathological features and prognosis of this condition, and breast metastasis remains a challenging clinical problem. A total of 54 cases of breast metastasis from gastric cancer were collected from databases between January 1960 and December 2016. The present study included 3 cases of gastric cancer with breast metastasis from Renji hospital and 51 additional cases from previous studies. The clinicopathological features of patients, including epidemiology, symptoms, macroscopic presentation, pathological diagnosis, imaging, treatment and overall survival time, were analyzed. The median survival time was 8.6 months. All but one of the patients were female, and the median age at diagnosis of breast metastasis was 43 years old (age range, 22–72 years). A majority of patients presented with Borrmann class III disease, signet ring cell carcinoma, T4 tumor types, lymph node involvement, initial stage IV gastric cancer, primary lesions in the gastric antrum, left breast metastasis and palpable breast nodules. The median interval between the primary gastric carcinoma diagnosis and presentation of breast metastasis was 1.25 months (range, 0–72 months). The expression of the estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2 and gross cystic disease fluid protein-15 was negative in the patients with breast metastases. In univariate analysis, age, gastric tumor size, gastric lymph node involvement and breast metastasis histology were significantly associated with overall survival (OS) time (P=0.001, 0.039, 0.034 and <0.001, respectively). Therapeutically, gastric surgery and chemotherapy were not associated with OS (P=0.959 and 0.290, respectively). In further multivariate analysis, the time between occurrence (P=0.017), age (P=0.009), histology (P=0.045) and breast metastasis localization (P=0.043) were independent indicators of OS time. Although breast metastasis from gastric cancer is rare, physicians should be vigilant when patients with a history of gastric cancer present with newly developed mammary symptoms and signs.

Significance of the Lysyl Oxidase Members Lysyl Oxidase Like 1, 3, and 4 in Gastric Cancer

Background/Aims: Lysyl oxidase (LOX) family members play a key role in modifying the primary tumor microenvironment by crosslinking collagens and elastin in the extracellular matrix. The aim of this study was to analyze the LOX-like (LOXL)1, LOXL3, and LOXL4 expressions in gastric cancer tissue by immunohistochemical staining. Methods: The correlations between the clinicopathological features of 597 primary gastric carcinomas and LOX family members – LOXL1, LOXL3, and LOXL4 – were investigated by immunohistochemical studies. The effect of the transforming growth ­factor β1 (TGFβ1) on the expressions of LOXL1, LOXL3, and LOXL4 in gastric cancer was examined using diffuse-type gastric cancer cell lines in vitro. Results: The expressions of LOXL1, LOXL3, and LOXL4 were correlated with T invasion, lymph node metastasis, and lymphatic and venous invasion. LOXL1 expression was associated with histological intestinal-type and expanding growth patterns. The overall survival of patients with LOXL1-, LOXL3-, or LOXL4-positive cancer was poorer than those with negative cancer. LOXL3 and LOXL4 mRNA expressions were significantly high in diffuse-type gastric cancer cells with high invasion ability. TGFβ decreased the LOXL1 expression and increased LOXL3 and LOXL4 expression. Conclusion: LOXL1, LOXL3, and LOXL4 expressions are associated with distant metastasis of gastric cancer.

Primary Gastric Small Cell Carcinoma: A Case Identified as a Large Subepithelial Tumor from Invisible State in 6 Months.

Primary gastric small cell carcinoma (GSCC) is one of the gastroenteropancreatic neuroendocrine tumors. It is a rare cancer with a very aggressive behavior and a poor prognosis because of the high rate of metastases. It is usually found in far advanced stage. We experienced a case of GSCC which had developed into a large subepithelial tumor (SET) from invisible state in a short period. A 65-year-old man consulted our hospital because of early gastric cancer. He underwent endoscopic submucosal dissection for the early gastric cancer at high body posterior wall. After 6 months, the follow-up endoscopy showed a large newly developed SET-like lesion with central ulceration at the gastric cardia. Endoscopic biopsy revealed GSCC. Total gastrectomy was performed. One out of the 26 perigastric lymph nodes had a metastasis. He received 6 cycles of adjuvant chemotherapy with etoposide and cisplatin. He is still in good health 12 months after operation.

Small cell carcinoma of the stomach: A report of two cases and a review of the literature.

Primary small cell gastric carcinomas (SCGC) are rare tumors with an aggressive nature, characterized by early, widespread metastases and poor overall prognosis. SCGC shares similar clinicopathological and molecular characteristics with small cell lung carcinoma and is usually treated in a similar manner. Here, two cases of SCGC in young Caucasian male patients are presented. One patient had metastatic and the other locoregional disease. Multimodal treatment was applied in each case; the resulting survival time was 20.2 months in the patient with initially locoregional disease whereas the remains alive and disease-free 20 months after initial diagnosis. A review of the literature is also presented.

A challenging diagnosis

Rationale:Oral metastases occur more commonly in bone, but can also manifest in soft tissues and eventually resemble a reactive lesion. Few cases of oral metastases mimicking reactive lesions in soft tissues have been reported to date.Patient concerns:We report a metastasis of gastric carcinoma (GC) to the oral mucosa without bone involvement in a 43 yom clinically and microscopically mimicking a reactive lesion. The patient related that the lesion had 1 month of evolution, and the ulcerated area suggested the lesion was related to trauma.Diagnoses:The histopathological examination of the lesion revealed an exuberant granulation tissue with few neoplastic cells, and the initial diagnosis of pyogenic granuloma was considered. In a second analysis, clusters of clear cells morphologically similar to degenerating mucous cells or macrophages, positive for Cytokeratin (CK)-20, and CDX2 were found. At the moment, it was confirmed the presence of a primary GC in the patient.Interventions:A palliative radiotherapy/chemotherapy was started.Outcomes:However, the patient died 3 months after the diagnosis of oral metastasis.Lessons:This report highlights the importance of careful clinical and microscopic examinations in cases of oral metastasis that may mimic a reactive lesion.

Metastatic Invasive Lobular Breast Carcinoma Mimicking Synchronous Breast and Gastric Cancers

Metastatic lobular carcinoma to stomach is seen as small round cells in linear cords within the normal tissue and it is not easily differentiated from signet cell adenocarcinoma of the stomach. Differentiating synchronous primary gastric carcinoma from metastatic involvement is vital in accurately planning treatment. Herein, we report a case of gastric metastatic invasive lobular breast carcinoma initially misdiagnosed as synchronous gastric and breast carcinoma and discuss the diagnostic and therapeutic challenges.

Malign mide çıkış obstrüksiyonunda endoskopik yöntemle metal stent uygulaması: Tersiyer bir merkezde beş yıllık tecrübe

Background and Aims: Malignant gastric outlet obstruction is a late and common complication of intra-abdominal malignancies, particularly primary pancreatic or gastric carcinomas. The majority of patients considered as unsuitable for curative surgical treatment require palliative treatment methods. Recently, endoscopic self-expendable metal stent placement, which is a minimally invasive method compared with surgery, has been performed more frequently than palliative surgery. The aim of this retrospective study was to evaluate the safety and efficacy of self-expendable metal stent placement in patients with inoperable malignant gastric outlet obstruction. Materials and Methods: This study analyzed the data of patients who underwent endoscopic uncovered self-expendable metal stents placement in the duodenum for treating malignant gastric outlet obstruction during a period of 5 years in our endoscopy unit. Technical and clinical success of the placement of duodenal self-expendable metal stents and the complications of the procedure were evaluated. Results: A total of 28 patients with malignant gastric outlet obstruction underwent endoscopic self-expendable metal stent placement. Technical success was achieved in all patients, while clinical success was observed in 25 patients (89%). According to the gastric outlet obstruction scoring system, the mean score of the patients was 0.536 before stent placement and improved significantly to 2.39 at the second week after stent placement (p = 0.0001). Major complications were observed in two patients (7.14%), and minor complications were observed in another two patients (7.14%). Conclusion: These findings indicate that endoscopic self-expendable metal stent placement was a safe and efficient palliative procedure for patients considered as unsuitable for curative surgical treatment of malignant gastric outlet obstruction.

An Unusual Presentation of Gastric Signet Ring Cell Carcinoma: Lower Back Pain as the Primary Symptom

An Unusual Presentation of Gastric Signet Ring Cell Carcinoma: Lower Back Pain as the Primary Symptom A 50 year old Hispanic woman was admitted with a 6 hour history of severe, shooting mid/lower back pain radiating to the upper left abdomen, sudden in onset, 10/10 intensity. She denied nausea, vomiting, and diarrhea. She had an episode of burning epigastric pain 2 months ago that resolved spontaneously, as well as another episode of back pain. She also reported a recent 15 pound weight loss. She had an H. pylori infection in the past which was treated. Her sister died of breast cancer. She drank alcohol occasionally but denied any drugs or cigarette use. On physical exam, she had normal vital signs but had tenderness in the left upper abdomen and lower paraspinal region. Laboratory studies were unremarkable except for an elevated ALP and CEA. CT scan of the abdomen and pelvis with contrast revealed thickening of the stomach wall and multiple enlarged lymph nodes. CT of the chest without contrast was remarkable for lytic lesions in the sternum and in the T1-L1 spine. An esophagogastroduodenoscopy was done, showing a circumferential, fungating and firm ulcerated mass with friable surfaces in the gastric body. Endoscopic ultrasound showed circumferential mucosal and submucosal thickening with hypoechoic islands in the gastric body, eroding into the propria and serosa with several enlarged lymph nodes. Primary gastric signet ring cell carcinoma (SRCC) was diagnosed on biopsy and was staged as T3N3M1. She declined to have a bone biopsy to confirm metastatic disease. She was not a surgical candidate and was eventually discharged on a course of chemotherapy. This is a unique case of SRCC due to the presenting symptom of back pain. Gastric carcinomas, especially SRCC, typically do not metastasize to the bone. The common sites of metastasis are the lymph nodes (35.4%), peritoneum (30.3%), liver (24.3%), and lung (10.4%). This case highlights the importance of a thorough clinical workup, using a combination of history, physical, labs and imaging. Without this, an uncommon presentation of a serious disease would likely have been missed.FigureFigureFigure

Clinicopathological features and prognosis of gastric adenosquamous carcinoma

Data about primary gastric adenosquamous carcinoma (ASC) was limited due to rare incidence. Thus, the present study aims to investigate clinicopathological features and prognosis of gastric ASC. Cases of gastric ASC were obtained from our center and from case reports and series extracted from Medline. Clinicopathological features and prognosis of gastric ASC were analyzed and compared with gastric adenocarcinoma (AC) in our center. The commonest location was lower third (45.0%), followed by upper (26.2%) and middle third (24.2%). The median tumor size was 6 cm (0.8–17). The commonest differentiation status was well for both AC (44.4%) and SCC components (40.9%). Half of tumors (52.7%) were stage T4 and most patients (86.2%) suffered from lymph node metastasis (LNM). Tumor depth and TNM stage were risk factors for overall survival (OS) (both P < 0.05). The distribution of age, tumor size, tumor location, tumor depth, LNM and TNM stage were significantly different between gastric ASC and AC (all P < 0.05). The OS of gastric ASC was significantly worse than AC (P < 0.001), especially in stage III disease (P < 0.001). Gastric ASC differ significantly from AC with respect to clinicopathological features. The prognosis of gastric ASC was worse than AC.

Abstract 1336: Significance of SERPINE2 expression in peritoneal metastasis in gastric carcinoma

Abstract Background: Peritoneal metastasis is one of the most frequent causes of death in patients with advanced gastric carcinoma (GC). However, molecular mechanisms driving peritoneal dissemination still remain poorly understood. Here, we aimed to give new insights to the molecular mechanisms that drive the peritoneal dissemination of GC. This study identified candidates of potential regulators of peritoneal dissemination and focused on the significance of one of them in vitro experiments and clinical samples. Methods: We utilized previously reported combined expression analysis with two cell lines and samples and 200 GC patients to identify driver genes of peritoneal dissemination. The cell lines consist of HSC58, an established cell lines from scirrhous type primary GC and its progeny cell line, 58As9, with in vivo-selected highly peritoneal metastatic potential. In vitro experiments, we utilized the two gastric cancer cell lines, 58As9 and NUGC4 and evaluated the effect of SERPINE2 knockdown on proliferation, spheroid formation, invasion, and motility. As for evaluation of clinical samples, 176 primary gastric carcinomas were included, which were obtained from patients who underwent curative gastrectomy in Kumamoto university between 2005 and 2015. We evaluated expression of SERPINE2 in immunohistochemistry and divided the cohort into two groups by SERPINE2 expression and analyzed relationship with clinicopathological factors and survival. Results: Enrichment analyses of the profile of the peritoneal dissemination-associated expression signature revealed that poor prognosis and peritoneal metastasis was related with the two pathways, focal adhesion (FDR q=0.00195) and extracellular matrix (FDR q=0.00195). Among the genes related with extracellular matrix, Serine Proteinase Inhibitor, Clade E, Member 2 (SERPINE2) was found to be highly expressed in 58As9 compared with HSC58, and we focused on SERPINE2 as a candidate of potential regulators of peritoneal dissemination. In vitro experiments, the SERPINE2 knockdown was related with decrease in cell motility and invasion, but not with decrease in proliferation, spheroid formation. Immunohistochemistry analysis of the clinical samples revealed higher SERPINE2 expression was significantly related with invasion of serosa and lymphatic vessels, and lymph node matastasis, and peritoneal metastatic metastasis. Survival analysis also revealed SERPINE2 expression was related with poor peritoneal recurrence-free survival (p=0.038), and peritoneal metastasis-specific survival (p=0.036). Conclusion: We found SERPINE2 as a candidate of driving molecules of peritoneal metastasis partly because it promotes invasive potential. Further study including in vivo study is required to reveal relationship of SERPINE2 with the other molecules and pathways. Citation Format: Daisuke Kuroda, Junji Kurashige, Hiroshi Sawayama, Masaaki Iwatsuki, Tomoyuki Uchihara, Tasuku Toihata, Eri Oda, Taisuke Yagi, Tsugio Eto, Keisuke Miyake, Mayuko Ouchi, Kenichi Nakamura, Koichi Kinoshita, Kousuke Mima, Takatsugu Ishimoto, Yasuo Sakamoto, Yoshifumi Baba, Naoya Yoshida, Koshi Mimori, Hideo Baba. Significance of SERPINE2 expression in peritoneal metastasis in gastric carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1336. doi:10.1158/1538-7445.AM2017-1336

Synchronously Diagnosed Gastric Metastasis from Invasive Lobular Breast Carcinoma, Mimicking Primary Gastric Carcinoma

Gastric metastasis from invasive lobular breast carcinoma is rare. Mostly gastrointestinal metastasis presents as one among multiple metastases, several years after primary diagnosis of breast carcinoma. Herein, we report a synchronously diagnosed gastric metastasis from invasive lobular carcinoma, mimicking primary gastric linitis plastica with pyloric obstruction. We reviewed clinical and pathological findings of gastric carcinoma metastatic from the breast. In particular, we focused on immunohistochemical studies of selected antibodies, including those for estrogen receptors, gross cystic disease fluid protein-15, and caudal-type homeobox transcription factor 2, for accurate differential diagnosis. Clinical suspicion, repeat endoscopic biopsy, and detailed histological analysis including immunohistochemistry are necessary for diagnosis of gastric carcinoma metastatic from the breast. Keywords: Breast; Carcinoma; Lobular; Neoplasm metastasis; Stomach

Clinicopathologic significance of the CXCL1-CXCR2 axis in the tumor microenvironment of gastric carcinoma.

PurposeIt was reported that the chemokine (C-X-C motif) ligand 1 (CXCL1) from cancer cells stimulated the recruitment of bone marrow-derived mesenchymal cells (BM-MCs) into tumor stroma via chemokine (C-X-C motif) receptor 2 (CXCR2) signaling. We conducted this retrospective study to determine the clinicopathologic significance of the CXCL1-CXCR2 axis in human gastric cancer.MethodsThe correlations between the clinicopathological features of 270 primary gastric carcinomas and CXCL1 in cancer cells and CXCR2 in stromal cells were analyzed in immunohistochemical studies. The effect of gastric cancer cells on the expression of CXCR2 in BM-MCs was examined using diffuse-type gastric cancer cell lines in vitro.ResultsThe expression of CXCL1 in cancer cells was correlated with T invasion (T2–T4), lymph node metastasis, lymphatic invasion, venous invasion, peritoneal cytology, peritoneal metastasis and CXCR2 expression in stromal cells. The expression of CXCR2 in stromal cells was correlated with macroscopic type-4 cancers, histological type, T invasion (T2–T4), lymph node metastasis, lymphatic invasion, infiltration, peritoneal cytology, peritoneal metastasis and CD271 expression in stromal cells. The overall survival of patients with CXCL1 and CXCR2-positive cancer was poorer than that of the patients with negative cancer. Both CXCL1 expression in cancer cells and CXCR2 expression in stromal cells were independent prognostic factors for gastric cancer patients.ConclusionThe expressions of CXCL1 in cancer cells and CXCR2 in stromal cells are useful prognostic factors for gastric cancer patients.

Five-year survival analysis of surgically resected gastric cancer cases in Japan: a retrospective analysis of more than 100,000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001-2007).

The aim of this retrospective study was to investigate the tumor characteristics, surgical details, and survival distribution of surgically resected cases of gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association. Data from 118,367 patients with primary gastric carcinoma who underwent resection between 2001 and 2007 were included in the survival analyses. The 5-year survival rates were calculated for various subsets of prognostic factors. The median age of the patients was 67years. The proportions of patients with pathological stage (Japanese Gastric Cancer Association) IA, IB, II, IIIA, IIIB, and IV disease were 44.0%, 14.7%, 11.7%, 9.5%, 5.0%, and 12.4% respectively. The death rate within 30days of operation was 0.5%. The 5-year overall survival rate in the 118,367 patients who were treated by resection was 71.1%. The 5-year overall survival rates of patients with pathological stage IA, IB, II, IIIA, IIIB, and IV disease were 91.5%, 83.6%, 70.6%, 53.6%, 34.8%, and 16.4% respectively. The 5-year disease-specific survival rates in the patients with pT1 (mucosa) disease after D1+dissection of lymph node station no. 7 (D1+α), D1+dissection of lymph node station nos. 7, 8, and 9 (D1+β), and D2 lymphadenectomy were 99.4%, 99.6%, and 99.1% respectively. The 5-year disease-specific survival rates in the patients with pT1 (submucosa) disease after D1+α, D1+β, and D2 lymphadenectomy were 97.3%, 98.1%, and 96.9% respectively. Detailed analyses of the data from more than 100,000 patients show the recent trends of the outcomes of gastric cancer treatment in Japan and provide baseline information for use by medical communities around world.

Primary gastric small cell carcinoma

Primary gastric small cell carcinoma

MET4 expression predicts poor prognosis of gastric cancers with Helicobacter pylori infection.

The role of HGF/SF‐MET signaling is important in cancer progression, but its relation with Helicobacter pylori‐positive gastric cancers remains to be elucidated. In total, 201 patients with primary gastric carcinoma who underwent curative or debulking resection without preoperative chemotherapy were studied. MET4 and anti‐HGF/SF mAbs were used for immunohistochemical analysis. Survival of gastric cancer patients was estimated by Kaplan–Meier method and compared with log‐rank. Cox proportional hazards models were fit to determine the independent association of MET‐staining status with outcome. The effect of live H. pylori bacteria on cell signaling and biological behaviors was evaluated using gastric cancer cell lines. MET4‐positive gastric cancers showed poorer prognosis than MET4‐negative cases (overall survival, P = 0.02; relapse‐free survival, P = 0.06). Positive staining for MET4 was also a statistically significant factor to predict poor prognosis in H. pylori‐positive cases (overall survival, P < 0.01; relapse‐free survival, P = 0.01) but not in H. pylori‐negative cases. Gastric cancers positively stained with both HGF/SF and MET4 showed a tendency of the worst prognosis. Stimulation of MET‐positive gastric cancer cells with live H. pylori bacteria directly upregulated MET phosphorylation and activated MET downstream signals such as p44/42MAPK and Akt, conferring cell proliferation and anti‐apoptotic activity. In conclusion, positive staining for MET4 was useful for predicting poor prognosis of gastric cancers with H. pylori infection. Helicobacter pylori stimulated MET‐positive gastric cancers and activated downstream signaling, thereby promoting cancer proliferation and anti‐apoptotic activity. These results support the importance of H. pylori elimination from gastric epithelial surface in clinical therapy.

Analysis of clinicopathological characteristics and prognosis on 42 patients with primary gastric adenosquamous cell carcinoma

To investigate the clinicopathological characteristics, diagnosis, treatment and prognosis of patients with primary gastric adenosquamous cell carcinoma. A total of 5 562 patients with gastric neoplasm were admitted in Tianjin Medical University Cancer Institute and Hospital from January 2001 to January 2011. Among them 42 patients were diagnosed as primary gastric adenosquamous cell carcinoma, accounting for 0.76% of all the patients. The clinicopathological and follow-up data of these 42 patients with primary gastric adenosquamous cell carcinoma were retrospectively analyzed, and Cox proportional hazard model was used to analyze the prognostic factors of gastric adenocarcinoma squamous cell carcinoma. Among above 42 patients, 32 were male and 10 were female, with a male-to-female ratio of 3.2/1.0 and the average age was 63 years (range: 46 to 77 years). Five patients (11.9%) were confirmed as adenosquamous cell carcinoma by preoperative pathological examination, while other 37 patients were diagnosed as adenocarcinoma preoperatively. According to the 7th edition AJCC TNM classification system for gastric adenocarcinoma, 5 patients (11.9%) were in stage II(, 30 patients (71.4%) in stage III( and 7 patients (16.7%) in stage IIII(. The maximum tumor diameter was > 5 cm in 18 patients (42.9%). Borrmann type III(-IIII( was found in 29 patients (69.0%), and poorly differentiated (or undifferentiated) tumor was found in 32 patients (76.2%). Radical operations were performed in 31 patients (73.8%), the reasons of non radical operations included infiltration of pancreas in 3 patients, infiltration of radices mesocili transvers in 1 patient and classification of stage IIII( in 7 patients. Lymph node dissection was performed in 37 patients, 83.8% of them (31/37) was found with lymphatic metastases. Twenty-five patients received adjuvant chemotherapy except for 7 patients in stage IIII( and 10 patients who refused adjuvant chemotherapy. All the patients had an average survival time of 36.4 months and median survival time of 28.0 months, and the overall 1-, 3- and 5-year survival rates were 82.2%, 42.3% and 18.2% respectively. Univariate analysis revealed that tumor size (χ2=4.039, P=0.044), Borrmann type (χ2=18.728, P=0.000), tumor differentiation (χ2=19.612, P=0.000), radical gastectomy (χ2=41.452, P=0.000), lymph node metastasis (χ2=9.689, P=0.002) and clinical stage (χ2=26.277, P=0.000) were associated with postoperative survival. Multivariate analysis revealed that tumor differentiation (HR=10.560, 95%CI:2.263-49.281, P=0.003), radical gastrectomy (HR=4.309, 95%CI:1.311-14.168, P=0.016) and clinical stage (HR=2.392, 95%CI:1.022-5.600, P=0.044) were independent prognosis factors. Primary gastric adenosquamous cell carcinoma is rare with poor prognosis. Radical gastrectomy is recommended. Tumor differentiation, radical gastrectomy and clinical stage are important indicators to evaluate prognosis of primary gastric adenosquamous cell carcinoma.

Primary Gastric Small Cell Carcinoma in Elderly Patients: A Case Report and Review of the Literature

Summary We report the case of an 86-year-old man with primary gastric small cell carcinoma (SmCC). He was admitted to our hospital owing to gastrointestinal bleeding complicated by anemia. An upper gastrointestinal endoscopic examination revealed a large, irregularly ulcerated tumor on the upper to middle body of the stomach. Small cell carcinoma was diagnosed based on the results of histologic and immunohistochemical studies of an endoscopic biopsy specimen. According to previous reports of gastric SmCC, only one-sixth of cases have been correctly diagnosed preoperatively. In our case, it was an aggressive malignancy that had an extremely poor prognosis. We believe that careful endoscopic examination including immunohistochemical investigation is necessary to accurately diagnose gastric SmCC in clinical practice.

Gastric metastases mimicking primary gastric cancer: A brief literature review

Gastric cancer is the fifth most common cancer worldwide, with most cases presenting in the form of primary tumors. In this paper, we performed a literature review on the incidence and particularities of extragastric metastases. These lesions are rare in clinical practice and can be misdiagnosed as primary undifferentiated gastric carcinomas as the differential diagnosis between primary and secondary malignancy is difficult to make. As per the literature, the most common malignancies which can present gastric metastases are lung cancer, followed by carcinoma of the breast, esophagus, kidney, and head and neck carcinomas. Malignant melanoma, ovarian cancer, prostate cancer, and adrenal gland carcinomas are rarely described as presenting metastases in the stomach. In most cases, the literature addressed poorly differentiated tumors with high-grade malignancy. The most common feature was the ulcerated tumor with depressed area, associated with identifiable extragastric tumor cells in the gastric submucosa. The linitis plastica-like feature is unusual and is more characteristic of breast lobular carcinoma. The accurate diagnosis of such rare extragastric metastatic cases depends on the appropriate clinical history and precise pathological diagnosis, which is mandatory for initiating the best therapeutic options.

A New Case of Primary Signet Ring Cell Carcinoma of the Uterine Cervix: A Case Report and Review of the Literature

Primary signet-ring cell carcinoma of cervix is extremely rare in the literature. Usually Signet-Ring Cell Carcinomas (SRCCs) of the cervix are metastatic from a primary gastric, colonic, ovarian, or breast carcinoma. A 48-year-old woman was referred to our Department due to persistent abnormal vaginal bleeding during the last two months. Gynecologic examination revealed cervical tumor. Biopsy revealed a signet ring cell type of mucinous adenocarcinoma. Extensive systemic examination reveals liver metastases biopsies confirmed. The patient was treated with palliative chemotherapy. The prognosis of primary signet ring cell adenocarcinoma of the uterine cervix is still unclear because of the rare incidence of cases. In this report we reviewed the literature to identify the clinical, pathological and immunohistochemical features of this rare malignancy.

A clinical case of primary gastric squamous cell carcinoma

A clinical case of primary gastric squamous cell carcinoma