A pancreatic metastasis from a colon cancer

Pancreatic metastases from colorectal cancer are extremely rare. We report the case of a 74-years-old patient presented with a metachronous pancreatic metastasis, which was treated by segmental pancreatectomy. After reviewing literature, diagnosis and management of pancreatic metastasis from colorectal carcinoma are discussed.     

A case of gastric metastasis of breast carcinoma resembling early gastric cancer]

Many patients suffering from breast carcinoma have metastases at initial diagnosis. The common metastatic sites are skeleton, liver and lung. Metastases to stomach are rare and only three cases have been reported in Korea. The endoscopic features of gastric metastases from breast carcinoma can be divided into three main categories: diffuse infiltration, external compression, and localized tumor deposition with ulceration or with a polypoid mass. However, metastatic gastric lesions which resemble early gastric carcinoma are rare. Typically, gastric metastases are confined to submucosa and muscularis, so that mucosal biopsy specimens might be false-negative. We report a case of gastric metastasis from infiltrative lobular carcinoma of the breast in a 66-year-old woman who had undergone left mastectomy with postoperative radiotherapy 17 years earlier. Initial diagnosis was early gastric carcinoma, signet ring cell type on gastric biopsy findings. However, definitive diagnosis of metastatic breast cancer was confirmed after endoscopic mucosal resection of a presumed primary early gastric carcinoma.     

A case of gastric cancer with isolated brain metastasis successfully managed by gamma knife radiotherapy and chemotherapy

We describe a 51-year-old man case of a huge gastric cancer with an initial presentation of isolated brain metastasis. The patient was successfully managed by gamma knife radiotherapy, followed by chemotherapy using 5-fluorouracil and cisplatin. He has continued oral administration of TS-1 on an outpatient basis with disease free survival for more than one year.     

Testicular metastasis from gastric carcinoma: A case report

Gastric cancer (GC) is the most prevalent malignancy in the world, especially in China. GC has been postulated to spread via several different routes, including through hematogenous channels, lymphatic vessels, the seeding of peritoneal surfaces, direct extension through the gastric wall, and retrograde extension through the vas deferens or lymphatics. Testicular metastasis is rare. We show here a 53-year-old patient with GC who underwent a radical total gastrectomy approximately 22 mo ago after he presented with a sensation of heaviness and swelling of the right hemiscrotum. The diagnosis of metastatic adenocarcinoma was made after a right-side orchiectomy. We report the first case of testicular metastasis from gastric adenocarcinoma in mainland China and summarize the clinicopathologic features of the disease based on previously published papers.     

A case of a small cell lung carcinoma presenting with jaundice due to pancreatic metastasis

Though the high incidence of pancreatic metastasis of lung cancer has been reported in autopsy series, symptomatic cases with jaundice due to that is very rare. Dominant histological type with pancreatic metastases is small cell carcinoma and prognosis is poor. Hereby, we report a case initially presenting with gastroenterologic symptoms as jaundice, nausea, vomiting, weight loss and abdominal pain and then diagnosed as primary small cell carcinoma of the lung with metastasis to pancreas. He underwent a palliative surgery due to obstructive jaundice. This presented case is a rare one with its priority of gastroenterologic symptoms rather than pulmonary complaints.     

A case of advanced gastric cancer with perianal skin metastasis]

The most common metastatic sites of gastric cancer are liver, lung, bone and adrenal gland. However, skin metastases from gastric cancer are relatively rare. We herein report a case of advanced gastric cancer with perianal skin metastasis in a 70-year-old male. On admission, patient presented with epigastric pain. Endoscopy and abdominal CT scan demonstrated the stage IV gastric cancer. He had one painless nodule on perianal skin area, biopsy of that lesion showed a feature of poorly differentiated adenocarcinoma clinically from the stomach. We suspected that the perianal lesion was originated from gastric cancer.     

Cerebellar metastasis as a unique presenting feature of gastric cancer.

Gastric cancer is often diagnosed in middle-aged patients undergoing upper gastrointestinal endoscopy for abdominal complaints or constitutional symptoms, such as dyspepsia, vomiting or anorexia, weight loss, anemia, jaundice, and ascites. Sometimes, all of these symptoms may be absent, and gastric cancer is diagnosed after detection of metastases to target organs, such as the liver or lung. In a few rare cases, however, even these metastatic localizations may be absent, and clinical signs are only represented by atypical symptoms caused by neurologic metastatic involvement. We report an exceptionally rare case of gastric cancer in which the only presenting symptoms were headache and dizziness caused by a single cerebellar metastasis.     

Cerebellar metastasis from pancreatic adenocarcinoma. A case report.

The first discovery of a cerebellar metastasis of pancreatic carcinoma in a living patient is described. Two years earlier the patient had undergone a pancreaticoduodenectomy for an adenocarcinoma of the head of the pancreas with a lymph node metastasis. After complete surgical removal of the tumor, he underwent adjuvant chemoradiation. Two years later the patient presented with intractable vomiting, which was attributed to peritoneal carcinomatosis. Clinical evaluation revealed an intracranial tumor without signs of pancreatic recurrence. The tumor was surgically removed. One year later the patient developed multiple brain metastases and he is currently undergoing gemcitabine-based chemotherapy.     

Solitary pancreas metastasis from AFP-producing gastric cancer: report of a case

We herein present a case of resected pancreatic metachronous metastasis arising from alpha-fetoprotein-producing gastric cancer. A 75-year-old man underwent distal gastrectomy for alpha-fetoprotein-producing gastric cancer in November 1999. The staging group of TNM classification was Stage IIIA. The serum AFP level normalized after surgical resection. During the follow-up period, it increased to 42ng/mL in January 2002, and up to 550ng/mL in July 2002: Abdominal computed tomography disclosed a 4-cm mass in the tail of the pancreas and under the diagnosis of pancreas metastasis, distal pancreatectomy with splenectomy was performed. Following this, serum alpha-fetoprotein declined to 61ng/mL, and the postoperative course was uneventful. But it elevated again to 200ng/mL in August, and to 3500ng/mL in September 2002. Computed tomography revealed multiple liver metastases. He was treated with TS-1, but hepatic lesions continued to grow and he died in March 2003. To our knowledge, this case is the first report of resection of solitary pancreas metastasis of alpha-fetoprotein-producing gastric cancer.     

Pericardiac metastasis from advanced gastric cancer

A 64-year-old man complaining of anterior chest pain, weight loss, and neck tumors was found to have advanced gastric cancer with pleuritis carcinomatosa and multiple lymph node and bone metastases. The patient was treated with combination chemotherapy consisting of mitomycin C (MMC), tegafur (UFT), and lentinan, and then with MMC and 5-fluorouracil (5FU) instillation into the pleural spaces after pleural drainage. With these treatments, the primary tumors and cancerous ulcers of the stomach improved markedly, and the lymph node enlargement and pleural effusion disappeared completely. Afterwards pericardiac metastasis complicated by cardiac tamponade occurred, but repeated pericardiocentesis and administration of MMC into the pericardiac cavity effectively eliminated the effusion. These treatments appeared potentially useful for advanced gastric cancer with generalized metastases including pericardiac involvement. However, the patient died of cardiac tamponade with massive pericardiac bleeding, probably due to the repeated pericardiocentesis and/or the administration of anticancer drugs.     

Postoperative isolated splenic metastasis from gallbladder cancer: report of a case

We present a rare case of metachronous splenic metastasis from gallbladder cancer. A 65-year-old female with gallbladder cancer underwent a partial hepatectomy with en-bloc resection of the gallbladder and extrahepatic bile duct. Ten months later, she presented with isolated splenic metastasis and underwent splenectomy with distal pancreatectomy. The histological diagnosis confirmed metastatic adenocarcinoma from gallbladder cancer. She had no signs of recurrence 4 years after the second surgery. To the best of our knowledge, this is the first report of isolated splenic metastasis from gallbladder cancer.