Gastric metastasis of ovarian serous cystadenocarcinoma

Isolated gastric metastasis of endometrioid carcinoma: a case report and literature review

Background

Isolated parenchymal gastric metastasis of endometrial cancer without other recurrence sites is extremely rare. This report presents a case of isolated gastric metastasis from endometrioid carcinoma characterized by a giant ulcer, which was managed with radical resection. Additionally, we review the recently published literature regarding isolated gastric metastases originating from ovarian and endometrial cancers.

Case Description

A 60-year-old female was admitted with discomfort in the upper abdomen accompanied by melena and a 6-year history of ovarian and endometrial cancer. Gastroscopy revealed a giant ulcer located in the gastric body, and biopsy pathology indicated a reproductive system origin. Subsequent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) revealed a hypermetabolic lesion within the gastric wall on the lesser curvature [standardized uptake value (SUV): 23.23]. Final pathology following total gastrectomy confirmed the presence of an isolated gastric metastasis tumor originating from primary endometrial endometrioid carcinoma. The patient was discharged 11 days postsurgery and exhibited no signs of recurrence or metastasis during a 3-month postoperative follow-up.

Conclusions

Early diagnosis and treatment are paramount for identifying metastatic gastric lesions. If surgery is feasible and safe, cytoreductive surgery followed by adjuvant chemotherapy represents an effective and widely endorsed treatment approach, significantly improving patient prognosis and enhancing long-term survival rates.

Asymptomatic Gastric Metastasis From Ovarian Adenocarcinoma Presented as Gastric Subepithelial Tumor: Case Report

Background

Ovarian tumor metastasis to the stomach is uncommon. Clinical manifestations of metastasis to the stomach are variable and lack features. Gastric metastasis resembling a subepithelial tumor is unusual, making the diagnosis challenging.

Case Presentation

Here, we reported a case of gastric metastasis from ovarian adenocarcinoma presenting as a subepithelial tumor diagnosed by endoscopic ultrasound-guided tissue acquisition.

Conclusion

This case provides significant reference value and serves as a cautionary reminder for the diagnosis and management of gastric subepithelial tumors.

Unveiling the Uncommon: Ovarian Cancer Metastasis as a Rare Cause of Obstructive Jaundice and Partial Gastric Outlet Obstruction

Ovarian malignancy leading to liver metastasis is relatively common in advanced stages; however, metastasis causing partial gastric outlet obstruction via duodenal encroachment is exceedingly rare. This case report details a 63-year-old woman initially diagnosed with ovarian serous cystadenocarcinoma who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH BSO) followed by chemotherapy and radiotherapy, achieving complete remission. Three years later, she developed metastasis to the caudate lobe of the liver, leading to duodenal and common bile duct (CBD) encroachment, resulting in partial gastric outlet obstruction and obstructive jaundice. Upon presentation in 2023, imaging and biopsy confirmed liver metastasis consistent with primary ovarian cancer. Despite initial chemotherapy reducing CA-125 levels, the patient experienced recurrent symptoms, including jaundice and gastrointestinal obstruction. Imaging revealed a mass in the liver causing duodenal and CBD compression. The management involved endoscopic retrograde cholangiopancreatography (ERCP) with biliary stent placement. This case underscores the importance of a multidisciplinary approach in managing rare metastatic patterns of ovarian cancer, emphasizing the need for continued follow-up and integrated care to optimize patient outcomes. Documentation of such cases is crucial for enhancing understanding and developing better management protocols for these rare occurrences.

Metastasis to the stomach: a systematic review

Background: This study reviews the literature on gastric metastases (GM) in terms of diagnosis, treatment, and outcomes. The goal of this study was to provide clinicians with a reliable and beneficial source to understand gastric metastases arising from various primary tumors and to present the growing literature in an easily accessible form. Methods: Articles published in English language from implementation of MEDLINE and Cochrane databases until May 2022 were considered for the systematic review. Articles other than English language, letters to the editor, posters, and clinical images were excluded. Hematogenous and lymphogenic metastases were included whereas direct tumoral invasion and seeding were excluded. Articles and abstracts were analyzed and last selection was done after cross-referencing and by use of defined eligibility criteria. Results: In total 1,521 publications were identified and 170 articles were finally included totaling 186 patients with GM. The median age of patients was 62 years. Gynecologic cancer was the most common cancer type causing GM (67 patients), followed by lung cancer (33 patients), renal cancer (20 patients), and melanoma (19 patients). One of the main treatment methods performed for metastasis was resection surgery (n=62), sometimes combined with chemotherapy (ChT) or immunotherapy. ChT was the other most used treatment method (n=78). Also, immunotherapy was amongst the most preferred treatment options after surgery and ChT (n=10). Conclusions: As 172 case reports were screened in the systematic review from different journals, heterogeneity was inevitable. Some articles missed important information such as complete follow-up or clinical information. Moreover, since all of the included articles were case reports quality assessment could not be performed. Among 172 case reports reviewed, resection surgery was performed the most and was sometimes combined with ChT and immunotherapy. Further research about what type of treatment has the best outcomes for patients with gastric metastases is needed.

Identification of Tumor Tissue of Origin with RNA-Seq Data and Using Gradient Boosting Strategy

BACKGROUND

Cancer of unknown primary (CUP) is a type of malignant tumor, which is histologically diagnosed as a metastatic carcinoma while the tissue-of-origin cannot be identified. CUP accounts for roughly 5% of all cancers. Traditional treatment for CUP is primarily broad-spectrum chemotherapy; however, the prognosis is relatively poor. Thus, it is of clinical importance to accurately infer the tissue-of-origin of CUP.

METHODS

We developed a gradient boosting framework to trace tissue-of-origin of 20 types of solid tumors. Specifically, we downloaded the expression profiles of 20,501 genes for 7713 samples from The Cancer Genome Atlas (TCGA), which were used as the training data set. The RNA-seq data of 79 tumor samples from 6 cancer types with known origins were also downloaded from the Gene Expression Omnibus (GEO) for an independent data set.

RESULTS

400 genes were selected to train a gradient boosting model for identification of the primary site of the tumor. The overall 10-fold cross-validation accuracy of our method was 96.1% across 20 types of cancer, while the accuracy for the independent data set reached 83.5%.

CONCLUSION

Our gradient boosting framework was proven to be accurate in identifying tumor tissue-of-origin on both training data and independent testing data, which might be of practical usage.

Identification of a 3-mRNA signature as a novel potential prognostic biomarker in patients with ovarian serous cystadenocarcinoma in G2 and G3

The use of mRNAs as biomarkers serves to diagnose, treat, as well as aid the prognosis of cancer. The present study involved an analysis of mRNAs in the cell cycle at the G2 and G3 tumor grades for the prognosis of ovarian serous cystadenocarcinoma (OSC) using 364 clinical samples (G2:G3=42:322). Statistics aided the identification of NPFFR2, XPNPEP2 and CELA3B; the 3-mRNA model that allows for classification of patients into high- and low-risk groups using a median value of 0.9580745. The rates of survival varied (P=0.00149) and the independent detection of stratification of the risk of this disease was validated with success using the 3-mRNA signature, which was demonstrated to be more successful than the weight model. This approach was revealed to provide the prognosis of grade G2 and G3 in patients with OSC compared with factors used traditionally. Compared with traditional factors, this 3-mRNA model was demonstrated to be the only and independent prognostic factor for patients with G2 and G3 stage OSC. A literature survey was also performed in the present study in order to assess the role of the 3 genes and indirectly prove their effectiveness. The establishment of this new genetic model will enhance prospective prognosis and treatment for patients with OSC.