Metastatic Colorectal Cancers Presenting as Multiple Superficial Type Lesions which Occurred Eight Years after Operation for Gastric Cancer, Report of a Case Shinsuke Matsunaga 1 , Hideo Tomioka 1 , Seiji Shimizu 1 1Department of Gastroenterology, JR West Osaka General Hospital Keyword: 転移性大腸癌 , 多発 , 胃癌 , 印環細胞癌 , 血行性転移 pp.1862-1868
Published Date 2003/12/25
DOI https://doi.org/10.11477/mf.1403100716
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 We encountered a 68-year-old woman who suffered multiple colorectal metastases eight years after an operation for gastric cancer. Barium enema X-ray and colonoscopy revealed about forty superficial-type lesions sized 5-20 mm throughout the entire large intestine and the terminal ileum. Ten lesions were resected endoscopically. All of the lesions were signet ring cell carcinoma confined to the lamina propria except for one with minimal submucosal invasion. The previously operated gastric cancer was IIc-like advanced cancer in the gastric body invading the proper muscle layer with lymph node metastasis. Its histology was signet ring cell carcinoma. Immunohistochemistry revealed that both the gastric lesion and the colorectal lesion shared the mucous characteristics of the gastric type. Accordingly, we concluded that the multiple colorectal lesions were metastases from the previously excised gastric cancer. CT scan of the chest and abdomen demonstrated no apparent mass lesions. Histological examination of the biopsy specimen of the bone marrow demonstrated the presence of signet ring cell carcinoma. Blood-born metastasis was suspected in this case.

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