Limits...
Uncommon mucosal metastases to the stomach.

Kanthan R, Sharanowski K, Senger JL, Fesser J, Chibbar R, Kanthan SC - World J Surg Oncol (2009)

Bottom Line: Poorly differentiated adenocarcinoma of the lung was demonstrated in a subsequent biopsy of "gastric polyps".Biopsies of the colonic and gastric mucosa demonstrated moderately differentiated invasive colonic adenocarcinoma with metastatic deposits in the stomach.While the accurate recognition of these lesions at endoscopy is fraught with difficulty, pathological awareness of such uncommon metastases in the gastric mucosa is essential for accurate diagnosis and optimal patient management.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology & Laboratory Medicine, College of Medicine, Saskatoon, Saskatchewan, Canada. rani.kanthan@saskatoonhealthregion.ca

ABSTRACT

Background: Metastases to the stomach from an extra-gastric neoplasm are an unusual event, identified in less than 2% of cancer patients at autopsy. The stomach may be involved by hematogenous spread from a distant primary (most commonly breast, melanoma or lung), or by contiguous spread from an adjacent malignancy, such as the pancreas, esophagus and gallbladder. These latter sites may also involve the stomach via lymphatic or haematogenous spread. We present three cases of secondary gastric malignancy.

Methods/results: The first is a 19-year-old male who received a diagnosis of testicular choriocarcinoma in September 2004. Metastatic malignancy was demonstrated in the stomach after partial gastrectomy was performed to control gastric hemorrhage. The second is a 75-year-old male, generally well, who was diagnosed with adenocarcinoma of the lung in September 2005. Poorly differentiated adenocarcinoma of the lung was demonstrated in a subsequent biopsy of "gastric polyps". The third is an 85-year-old man with no known history of malignancy who presented for evaluation of iron deficiency anemia by endoscopy in February 2006. Biopsies of the colonic and gastric mucosa demonstrated moderately differentiated invasive colonic adenocarcinoma with metastatic deposits in the stomach.

Conclusion: While the accurate recognition of these lesions at endoscopy is fraught with difficulty, pathological awareness of such uncommon metastases in the gastric mucosa is essential for accurate diagnosis and optimal patient management.

Show MeSH

Related in: MedlinePlus

Histopathology of the Testis Hematoxylin and eosin stained, medium power, magnification ×250. A. Mixed germ cell tumor of the testis – highlighting a focus of primary choriocarcinoma as seen by the presence of black triangle – cytotrophoblast and * – syncytiotrophoblast cells. B. Mixed germ cell tumor of the testis – highlighting a focus of embryonal carcinoma associated with * – multiple foci of necrosis. C. Metastatic testicular choriocarcinoma – as seen by the presence of * – metastatic trophoblastic cells with areas of black triangle – central necrosis admixed with # – gastric glands.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2734526&req=5

Figure 1: Histopathology of the Testis Hematoxylin and eosin stained, medium power, magnification ×250. A. Mixed germ cell tumor of the testis – highlighting a focus of primary choriocarcinoma as seen by the presence of black triangle – cytotrophoblast and * – syncytiotrophoblast cells. B. Mixed germ cell tumor of the testis – highlighting a focus of embryonal carcinoma associated with * – multiple foci of necrosis. C. Metastatic testicular choriocarcinoma – as seen by the presence of * – metastatic trophoblastic cells with areas of black triangle – central necrosis admixed with # – gastric glands.

Mentions: Figure 1A illustrates the primary choriocarcinoma of the testicle as characterized by a biphasic proliferation of malignant trophoblastic cells: centrally, cytotrophoblastic cells (black triangle) which have clear cytoplasm and mild to moderate nuclear pleomorphism, and above these a "cap" of syncytiotrophoblast cells (*), which demonstrate abundant amphophilic cytoplasm, smudged nuclear chromatin and multinucleation. Often, hemorrhage and necrosis are seen centrally within the mass of cytotrophoblasts. If syncytiotrophoblast cells are inconspicuous, this lesion may be difficult to differentiate from embryonal carcinoma with cellular degeneration.


Uncommon mucosal metastases to the stomach.

Kanthan R, Sharanowski K, Senger JL, Fesser J, Chibbar R, Kanthan SC - World J Surg Oncol (2009)

Histopathology of the Testis Hematoxylin and eosin stained, medium power, magnification ×250. A. Mixed germ cell tumor of the testis – highlighting a focus of primary choriocarcinoma as seen by the presence of black triangle – cytotrophoblast and * – syncytiotrophoblast cells. B. Mixed germ cell tumor of the testis – highlighting a focus of embryonal carcinoma associated with * – multiple foci of necrosis. C. Metastatic testicular choriocarcinoma – as seen by the presence of * – metastatic trophoblastic cells with areas of black triangle – central necrosis admixed with # – gastric glands.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2734526&req=5

Figure 1: Histopathology of the Testis Hematoxylin and eosin stained, medium power, magnification ×250. A. Mixed germ cell tumor of the testis – highlighting a focus of primary choriocarcinoma as seen by the presence of black triangle – cytotrophoblast and * – syncytiotrophoblast cells. B. Mixed germ cell tumor of the testis – highlighting a focus of embryonal carcinoma associated with * – multiple foci of necrosis. C. Metastatic testicular choriocarcinoma – as seen by the presence of * – metastatic trophoblastic cells with areas of black triangle – central necrosis admixed with # – gastric glands.
Mentions: Figure 1A illustrates the primary choriocarcinoma of the testicle as characterized by a biphasic proliferation of malignant trophoblastic cells: centrally, cytotrophoblastic cells (black triangle) which have clear cytoplasm and mild to moderate nuclear pleomorphism, and above these a "cap" of syncytiotrophoblast cells (*), which demonstrate abundant amphophilic cytoplasm, smudged nuclear chromatin and multinucleation. Often, hemorrhage and necrosis are seen centrally within the mass of cytotrophoblasts. If syncytiotrophoblast cells are inconspicuous, this lesion may be difficult to differentiate from embryonal carcinoma with cellular degeneration.

Bottom Line: Poorly differentiated adenocarcinoma of the lung was demonstrated in a subsequent biopsy of "gastric polyps".Biopsies of the colonic and gastric mucosa demonstrated moderately differentiated invasive colonic adenocarcinoma with metastatic deposits in the stomach.While the accurate recognition of these lesions at endoscopy is fraught with difficulty, pathological awareness of such uncommon metastases in the gastric mucosa is essential for accurate diagnosis and optimal patient management.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology & Laboratory Medicine, College of Medicine, Saskatoon, Saskatchewan, Canada. rani.kanthan@saskatoonhealthregion.ca

ABSTRACT

Background: Metastases to the stomach from an extra-gastric neoplasm are an unusual event, identified in less than 2% of cancer patients at autopsy. The stomach may be involved by hematogenous spread from a distant primary (most commonly breast, melanoma or lung), or by contiguous spread from an adjacent malignancy, such as the pancreas, esophagus and gallbladder. These latter sites may also involve the stomach via lymphatic or haematogenous spread. We present three cases of secondary gastric malignancy.

Methods/results: The first is a 19-year-old male who received a diagnosis of testicular choriocarcinoma in September 2004. Metastatic malignancy was demonstrated in the stomach after partial gastrectomy was performed to control gastric hemorrhage. The second is a 75-year-old male, generally well, who was diagnosed with adenocarcinoma of the lung in September 2005. Poorly differentiated adenocarcinoma of the lung was demonstrated in a subsequent biopsy of "gastric polyps". The third is an 85-year-old man with no known history of malignancy who presented for evaluation of iron deficiency anemia by endoscopy in February 2006. Biopsies of the colonic and gastric mucosa demonstrated moderately differentiated invasive colonic adenocarcinoma with metastatic deposits in the stomach.

Conclusion: While the accurate recognition of these lesions at endoscopy is fraught with difficulty, pathological awareness of such uncommon metastases in the gastric mucosa is essential for accurate diagnosis and optimal patient management.

Show MeSH
Related in: MedlinePlus