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Pichioni P, Kokkinovasilis D, Stylianou S, Kipouridis G, Kalogeropoulos A, Al Mogrampi S. Multiple Muscle Metastases as the First Presentation of Gastric Cancer: A Case Report and Review of Literature. Cureus 2024; 16:e55458. [PMID: 38571840 PMCID: PMC10988182 DOI: 10.7759/cureus.55458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 04/05/2024] Open
Abstract
The presence of an abdominal wall mass may serve as the initial presentation of an unknown gastric malignancy. The invasion of the abdominal wall and the occurrence of multiple skeletal muscle metastases originating from gastric cancer are exceedingly uncommon. We present a case of a 45-year-old female patient exhibiting widespread abdominal wall infiltration and skeletal muscle metastases derived from gastric cancer. The primary presentation included a distressing diffuse abdominal mass in the left upper and lower quadrants. Abdominal computed tomography revealed extensive swelling of multiple skeletal muscles within the abdominal wall, raising suspicions of gastric malignancy. Biopsies of the affected muscles, along with upper gastrointestinal tract endoscopy and colonoscopy, were performed. The upper endoscopy examination unveiled a poorly differentiated diffuse-type gastric adenocarcinoma, while the subsequent muscle biopsy confirmed infiltration by the recently diagnosed malignancy. At this stage of the disease, systemic chemotherapy was deemed the optimal choice for our patient. Subsequent abdominal computed tomography showed a decrease in the dimensions of the abdominal wall and other skeletal muscle lesions. Seventeen months after the initial diagnosis, our patient continues to be alive. Additionally, we provide a comprehensive review of the existing literature on similar reported cases of gastric cancer patients with concurrent muscle metastases.
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Affiliation(s)
- Polyxeni Pichioni
- Department of Surgery, General Hospital of Imathia, Naousa Health Unit, Naousa, GRC
| | | | - Stylianos Stylianou
- Department of Surgery, General Hospital of Imathia, Naousa Health Unit, Naousa, GRC
| | - Georgios Kipouridis
- Department of Surgery, General Hospital of Imathia, Naousa Health Unit, Naousa, GRC
| | | | - Saant Al Mogrampi
- Department of Surgery, General Hospital of Imathia, Naousa Health Unit, Naousa, GRC
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Jacob E, Smucker L, Crouse R, Allard-Picou A. Isolated brachioradialis metastasis of gastric adenocarcinoma after R0 resection. World J Surg Oncol 2021; 19:83. [PMID: 33743738 PMCID: PMC7981802 DOI: 10.1186/s12957-021-02191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gastric cancer is the fifth most common cancer worldwide, with an incidence of 6.72 per 100,000 people. Thirty-two percent of gastric cancer patients will live 5 years after diagnosis. Single-site metastasis is noted in 26% of patients with gastric cancer, most commonly in the liver (48%), peritoneum (32%), lung (15%), and bone (12%). Here, a case is presented in which a single skeletal muscle metastasis appeared after appropriate resection and treatment. CASE PRESENTATION A 63-year-old man underwent neoadjuvant chemotherapy and a multivisceral en bloc R0 resection. Final pathology showed no evidence of lymph node metastasis with 31 negative lymph nodes. Four months postoperatively, the patient was found to have a rapidly growing biopsy-proven extremity soft tissue gastric metastasis within the brachioradialis muscle. He subsequently underwent metastasectomy and immunotherapy. CONCLUSION This case is a rare example of an isolated extremity metastasis of gastric adenocarcinoma in the setting of an R0 resection of the primary tumor and negative nodal disease on final pathology, suggestive of hematogenous spread. We review the biology, workup, and management of gastric cancer and highlight new advancements in the treatment of this aggressive cancer.
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Affiliation(s)
- Elizabeth Jacob
- Department of Surgery, Bassett Medical Center, Cooperstown, NY, USA
| | - Levi Smucker
- Department of Surgery, Bassett Medical Center, Cooperstown, NY, USA.
| | - Ryan Crouse
- Department of Surgery, Bassett Medical Center, Cooperstown, NY, USA
| | - Ayana Allard-Picou
- Department of Surgery, Bassett Medical Center, Cooperstown, NY, USA
- Columbia University College of Physicians and Surgeons, New York City, USA
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Korehisa S, Kabashima A, Ichimanda M, Umeda K, Koso H, Yada K, Arakane M, Anai H. Gluteal muscle metastasis with peritoneal dissemination from gastric cancer during postoperative adjuvant chemotherapy: a case report. Surg Case Rep 2021; 7:42. [PMID: 33547982 PMCID: PMC7867502 DOI: 10.1186/s40792-021-01127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/31/2021] [Indexed: 11/10/2022] Open
Abstract
Background Skeletal muscle metastasis from gastric cancer is rare and has a poor prognosis. We reported a case of gluteal muscle metastasis with peritoneal dissemination from gastric cancer during postoperative adjuvant chemotherapy. Case presentation A 64-year-old man with gastric cancer underwent distal gastrectomy with D2 lymph node resection. The pathological diagnosis was poorly differentiated adenocarcinoma and signet cell carcinoma, T3N3bM0, Stage IIIC. Metastases were found in all regional lymph nodes, except 11p. The resection margin was negative. S-1 plus docetaxel therapy was administered as postoperative adjuvant chemotherapy. Six month post-operation, the patient presented with right gluteal muscle tenderness and abdominal distension. Computed tomography revealed a solid mass in the right gluteal muscle, a disseminated nodule on the abdominal wall, and massive ascites. Pathological examination of the gluteal muscle revealed signet cell carcinoma, similar to the resected gastric cancer. The tumor was diagnosed as gastric cancer metastases. Ascites cytology was class V. Thereafter, the patient underwent one course of capecitabine plus cisplatin combined with trastuzumab. Radiation therapy was also administered to relieve the pain of gluteal muscle metastasis. However, chemoradiotherapy was ineffective, and the patient died 2 months after the recurrence. Conclusions Skeletal muscle metastasis and peritoneal dissemination during adjuvant chemotherapy indicated a poor prognosis.
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Affiliation(s)
- Shotaro Korehisa
- Department of Surgery, National Hospital Organization, Oita Medical Center, 2-11-45 Yokota, Oita, 870-0263, Japan
| | - Akira Kabashima
- Department of Surgery, National Hospital Organization, Oita Medical Center, 2-11-45 Yokota, Oita, 870-0263, Japan.
| | - Michihiro Ichimanda
- Department of Surgery, National Hospital Organization, Oita Medical Center, 2-11-45 Yokota, Oita, 870-0263, Japan
| | - Kenji Umeda
- Department of Surgery, National Hospital Organization, Oita Medical Center, 2-11-45 Yokota, Oita, 870-0263, Japan
| | - Hidenori Koso
- Department of Surgery, National Hospital Organization, Oita Medical Center, 2-11-45 Yokota, Oita, 870-0263, Japan
| | - Kazuhiro Yada
- Department of Surgery, National Hospital Organization, Oita Medical Center, 2-11-45 Yokota, Oita, 870-0263, Japan
| | - Motoki Arakane
- Department of Pathology, National Hospital Organization, Oita Medical Center, 2-11-45 Yokota, Oita, 870-0263, Japan
| | - Hideaki Anai
- Department of Surgery, National Hospital Organization, Oita Medical Center, 2-11-45 Yokota, Oita, 870-0263, Japan
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Di Stadio A, D'Ascanio L, Latini G, Gradoni P, Pandolfini M, Tamburrano T, Ricci G, Maranzano M, Brenner MJ. Metastatic signet ring cell gastric carcinoma bypassing Virchow's node: An unexpected etiology of a painful neck mass. Clin Case Rep 2021; 9:650-653. [PMID: 33598219 PMCID: PMC7869360 DOI: 10.1002/ccr3.3594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 11/21/2022] Open
Abstract
Metastatic lymph nodes of the head and neck are often associated with locoregional spread of mucosal squamous carcinoma, but in rare instances visceral malignancies may bypass Virchow's node. The possibility of distant metastasis should be considered.
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Affiliation(s)
| | - Luca D'Ascanio
- Department of Head and Neck SurgeryInstitute of OtorhinolaryngologySanta Croce Hospital AORMNFanoItaly
| | - Gino Latini
- Department of Head and Neck SurgeryInstitute of OtorhinolaryngologySanta Croce Hospital AORMNFanoItaly
| | - Paolo Gradoni
- Department of Head and Neck SurgeryInstitute of OtorhinolaryngologySanta Croce Hospital AORMNFanoItaly
| | - Manlio Pandolfini
- Department of Head and Neck SurgeryInstitute of OtorhinolaryngologySanta Croce Hospital AORMNFanoItaly
| | | | | | - Massimo Maranzano
- CFU of Head and Neck SurgeryDivision of Oral and Maxillofacial and Facial Plastic SurgeryManchester University Foundation TrustManchesterUK
| | - Michael J. Brenner
- Division of Facial Plastic and Reconstructive SurgeryDepartment of Otolaryngology‐Head and Neck SurgeryUniversity of Michigan Medical SchoolAnn ArborMIUSA
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Daneti D, Senthamizhselvan K, Verma SK, Mohan P. Gastric adenocarcinoma presenting with multiple skeletal muscle metastases. BMJ Case Rep 2021; 14:14/1/e239518. [PMID: 33462054 PMCID: PMC7813375 DOI: 10.1136/bcr-2020-239518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
A 42-year-old man presented to the gastroenterology clinic with features of gastric outlet obstruction, significant weight loss, anaemia, ascites, and pain in the lower back and left thigh. CT scan of the abdomen and pelvis showed wall thickening in the antropyloric region of the stomach and enhancing soft tissue lesion in the left psoas and right gluteal region. Gastroscopy revealed a circumferential growth in the antrum and pylorus of the stomach, and biopsy from the growth was reported as moderately differentiated adenocarcinoma. Positron emission tomography-CT scan showed multiple skeletal muscle metastases all over the body. Fine-needle aspiration cytology and immunohistochemistry from the psoas lesion confirmed metastatic adenocarcinoma deposits. He underwent antropyloric stenting for his obstructive symptoms and received supportive care, finally succumbed to his illness after 6 weeks.
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Affiliation(s)
- Dharanesh Daneti
- Medical Gastroenterology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
| | - Kuppusamy Senthamizhselvan
- Medical Gastroenterology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
| | - Surendra Kumar Verma
- Pathology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
| | - Pazhanivel Mohan
- Medical Gastroenterology, Jawaharlal Institute of Post Graduate Medical Education, Pondicherry, Puducherry, India
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