A CASE OF METASTATIC CARCINOMA OF THE COLON FROM GASTRIC CANCER 5 YEARS AFTER CURATIVE RESECTION

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  • 胃癌治癒切除後５年で発症した転移性大腸癌の１例

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Abstract

The patient was a 68-year-old woman, who had undergone a total gastrectomy for type 4 advanced gastric cancer about 5 years earlier which was poorly differentiated adenocarcinoma involving signet ring cell carcinoma, pT3 (se). pN0, H0, P0, M0, Stage II, scirrhous type, ly1 and v0. Thereafter she had been given oral anticancer agent 5'-DFUR for 2 years as postoperative adjuvant chemotherapy. This time she was seen at the hospital because of lower abdominal pain and abdominal distension. Lower gastrointestinal series showed apple core sign in the transverse colon at the splenic flexure. Lower gastrointestinal endoscopy revealed a remarkable narrowing encircling the lumen and the mucosa showed redness and was edematous and easily bleeding. The histological diagnosis was poorly differentiated adenocarcinoma involving signet ring cell carcinoma. The patient was operated on with the diagnosis of primary or metastatic colonic carcinoma. Immunohistologically the tumor was positive for CK7, CK19, and MUC5AC and negative for CK20, MUC1 and MUC2. Reviewing the preparation of gastric cancer which was thought to be the primary focus disclosed that the both preparations were the same in the histologic type and results of immunohistological stainings. Thus metastatic carcinoma of the colon from gastric carcinoma was diagnosed.

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