A Case of Gastric Carcinoma that Metastasized to the Skin and Inguinal Lymph Nodes 7 and 13 Years after Gastrectomy
A 65-year-old man visited our hospital for right inguinal tumor. He had undergone gastrectomy for gastric carcinoma 13 years ago. Histopathologically, it was poorly differentiated adenocarcinoma, classified as t2(ss)n0M0 stage Ib according to the 12th edition of the Japanese Classification of Gastri...
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| Published in | The Japanese Journal of Gastroenterological Surgery Vol. 46; no. 3; pp. 159 - 166 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society of Gastroenterological Surgery
2013
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9768 1348-9372 |
| DOI | 10.5833/jjgs.2012.0169 |
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| Abstract | A 65-year-old man visited our hospital for right inguinal tumor. He had undergone gastrectomy for gastric carcinoma 13 years ago. Histopathologically, it was poorly differentiated adenocarcinoma, classified as t2(ss)n0M0 stage Ib according to the 12th edition of the Japanese Classification of Gastric Carcinoma. Six years ago, he underwent resection and radiation therapy for cutaneous metastasis of the right posterior head. Physical examination revealed a 3-cm elastic hard mass with good movement in the right inguinal portion. CT of the neck, chest, and body showed a tumor of 2.7×2.5×1.2 cm in the right inguinal portion. No other metastasis was found. Tumor resection biopsy was performed under local anesthesia. Histopathologically, it was lymph node metastasis from gastric carcinoma. Cutaneous metastasis and inguinal lymph nodal metastasis are often encountered as part of systemic metastasis in the terminal stage of gastric carcinoma, but solitary metastasis is very rare. Delayed metastasis, 7 and 13 years after gastrectomy, is also rare. We report and review this case with a review of the literature. |
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| AbstractList | A 65-year-old man visited our hospital for right inguinal tumor. He had undergone gastrectomy for gastric carcinoma 13 years ago. Histopathologically, it was poorly differentiated adenocarcinoma, classified as t2(ss)n0M0 stage Ib according to the 12th edition of the Japanese Classification of Gastric Carcinoma. Six years ago, he underwent resection and radiation therapy for cutaneous metastasis of the right posterior head. Physical examination revealed a 3-cm elastic hard mass with good movement in the right inguinal portion. CT of the neck, chest, and body showed a tumor of 2.7×2.5×1.2 cm in the right inguinal portion. No other metastasis was found. Tumor resection biopsy was performed under local anesthesia. Histopathologically, it was lymph node metastasis from gastric carcinoma. Cutaneous metastasis and inguinal lymph nodal metastasis are often encountered as part of systemic metastasis in the terminal stage of gastric carcinoma, but solitary metastasis is very rare. Delayed metastasis, 7 and 13 years after gastrectomy, is also rare. We report and review this case with a review of the literature. |
| Author | Fukuchi, Nariaki Nishijima, Junichi Okuyama, Masaki Endo, Shunji Konishi, Ken Yamada, Terumasa Dousei, Tsutomu Miyazaki, Satoru Yamauchi, Amane Sakata, Kazuya |
| Author_xml | – sequence: 1 fullname: Endo, Shunji organization: Department of Surgery, Higashiosaka City General Hospital – sequence: 1 fullname: Okuyama, Masaki organization: Department of Surgery, Higashiosaka City General Hospital – sequence: 1 fullname: Yamada, Terumasa organization: Department of Surgery, Higashiosaka City General Hospital – sequence: 1 fullname: Sakata, Kazuya organization: Department of Surgery, Higashiosaka City General Hospital – sequence: 1 fullname: Fukuchi, Nariaki organization: Department of Surgery, Higashiosaka City General Hospital – sequence: 1 fullname: Konishi, Ken organization: Department of Surgery, Higashiosaka City General Hospital – sequence: 1 fullname: Dousei, Tsutomu organization: Department of Surgery, Higashiosaka City General Hospital – sequence: 1 fullname: Nishijima, Junichi organization: Department of Surgery, Higashiosaka City General Hospital – sequence: 1 fullname: Miyazaki, Satoru organization: Department of Surgery, Social Insurance Kinan Hospital – sequence: 1 fullname: Yamauchi, Amane organization: Department of Diagnostic Pathology, Higashiosaka City General Hospital |
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| References_xml | – reference: 4) 草間 悟．胃癌の再発時期を左右する諸因子について．胃と腸．1977;12(1):61–72. – reference: 15) 菊池 康，松山 麻子，野村 和夫，貝森 光大．青森県立中央病院皮膚科における転移性皮膚癌の統計的，病理組織学的観察．臨床皮膚科．1999;53(12):977–981. – reference: 12) 福井 佳子，徐 信夫，前島 精治，酒谷 省子，草壁 秀成，清金 公裕．転移性皮膚癌32症例の統計学的観察．皮膚．1995;37(5):534–543. – reference: 10) 田中 信治，平田 学，鈴木 武彦，津田 敏孝，井上 和彦，豊島 仁，ほか．皮膚転移が先行したスキルス胃癌の1例．広島医学．1990;43(11):1884–1889. – reference: 20) 秋本 亮一，溝淵 昇，土谷 昇二，古屋 平和，山崎 忠光，榊原 宣．広範な転移を伴った早期胃癌の1例．日本消化器外科学会雑誌．1991;24(1):103–107. – reference: 21) 河田 直海，鈴木 偉一，斎藤 真悟，船津 隆，小林 展章．両側鼠径リンパ節および多発骨転移を伴った早期胃癌の1例．日本消化器外科学会雑誌．1992;25(12):2973–2977. – reference: 14) Yamamura Y, Kodera Y, Kito T. Gastric cancer with carcinoma erysipeloides caused by spontaneous thoracic duct rupture: report of a case. Surg Today. 1997;27(2):166–168. – reference: 17) 佐藤 三佳，江崎 智香子，神谷 秀喜，北島 康雄．特異な外観を呈した胃癌の皮膚転移．皮膚科の臨床．2009;51(2):219–221. – reference: 19) Zaren HA, Copeland EM 3rd. Inguinal node metastases. Cancer. 1978;41(3):919–923. – reference: 6) 加藤 貞明，片岡 徹，河村 正敏，河村 一敏．胃癌術後晩期再発（術後5年以降の再発）に関する臨床病理学的検討．昭和医学会雑誌．1986;46(4):517–532. – reference: 8) 辻 卓夫．転移性皮膚癌．皮膚科の臨床．2004;46(1):45–53. – reference: 5) Sano T, Sasako M, Kinoshita T, Maruyama K. Recurrence of early gastric cancer. Follow-up of 1475 patients and review of the Japanese literature. Cancer. 1993;72(11):3174–3178. – reference: 13) Fujiwara S, Ichikawa H, Matsunaga E, Shinkai H, Takayasu S, Wada K, et al. Delayed cutaneous metastasis of gastric carcinoma. J Dermatol. 1989 Jun;16(3):242–246. – reference: 3) 日本胃癌学会編．胃癌取扱い規約．第12版．東京：金原出版；1993. p. 2-51. – reference: 18) 亀田 久仁郎，久保 章，門倉 俊明，田中 優作，長嶺 弘太郎，吉田 謙一，ほか．術後9年目に髄膜癌腫症で再発した早期胃癌の1例．日本臨床外科学会雑誌．2009;70(12):3561–3564. – reference: 1) 中村 順哉，長尾 二郎，中村 集，清水 義金，桜井 貞夫，柁原 宏久，ほか．胃癌術後7年6カ月目に皮膚転移を来し切除後2年6カ月を経過した1例．日本臨床外科医学会雑誌．1995;56(1):108–110. – reference: 22) Morita M, Baba H, Taketomi A, Kohnoe S, Tomoda H, Fukuda T, et al. Inguinal lymph node recurrence of mucosal cancer of the stomach. Oncol Rep. 1997;4(4):713–715. – reference: 2) 中村 勝也，佐藤 裕，中村 賢二郎，亀井 隆史，黒木 祥司，高嶋 雅樹，ほか．異時性に多発腹腔外転移を来しながら初回手術より7年2カ月生存した胃癌の1例．日本臨床外科学会雑誌．2000;61(1):97–101. – reference: 9) 野田 佳子，漆畑 修，武田 朋子，西川 律子，西脇 宗一，若山 恵，ほか．紅斑型転移性皮膚癌Borrmann 4型胃癌を原発とした1例．臨床皮膚科．1989;43(5):485–489. – reference: 7) 岩永 剛，田中 元，小山 博記，古河 洋．胃癌晩期再発例の検討─外科臨床の立場から．胃と腸．1977;12(1):21–31. – reference: 16) 田儀 知之，植木 孝宜，桜井 喜代美，小野 滋，中路 啓介，山岸 久一．早期胃癌（深達度m）根治術後5年目に皮膚転移をきたした1例．日本臨床外科学会雑誌．2004;65(6):1544–1547. – reference: 11) 堀 真，吉田 彦太郎．皮膚病変からみた内臓癌 転移性皮膚癌の統計的観察 原発臓器，転移部位，予後と病理組織像．癌と化学療法．1988;15(4):1576–1580. |
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| Title | A Case of Gastric Carcinoma that Metastasized to the Skin and Inguinal Lymph Nodes 7 and 13 Years after Gastrectomy |
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