Yıl: 2021 Cilt: 37 Sayı: 3 Sayfa Aralığı: 203 - 211 Metin Dili: İngilizce DOI: 10.5146/tjpath.2021.01529 İndeks Tarihi: 29-05-2022

Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries

Öz:
Objective: Metastatic involvement of the stomach is a rare event. Our aim in this study was to document the clinicopathological findings in patients with gastric metastases and find out if there are any potentially significant features to be used in the differential diagnosis. Material and Method: Our cohort consisted of 17 histologically verified gastric metastasis cases. Clinical, endoscopic and microscopic features were retrospectively analyzed. Results: The primary sites were the breast, skin, lungs, ovaries, colon, and gluteal soft tissue. Three patients were symptomatic because of the metastatic involvement of the stomach and 9 patients had concomitant metastasis in other sites. Invasive lobular breast carcinoma and malignant melanoma were the most common metastatic malignancies. The most common macroscopic appearance was the diffuse infiltrative type (Borrmann Type 4). Most of the metastatic lesions endoscopically mimicked primary gastric cancer. Furthermore, some of the metastatic lesions, particularly invasive lobular carcinoma of the breast and malignant melanoma, displayed histopathologic features similar to the primary gastric malignancies to a certain extent. Conclusion: The possibility of metastatic involvement of stomach must be kept in mind while dealing with a gastric mass lesion in a cancer patient, even though the clinical and endoscopic features suggest primary gastric cancer. Our study points out the importance of conveying the information about medical history and clinical findings of the patients for correct pathologic differential diagnosis.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Donahue-Iacobuzio C, Groisman GM. Secondary tumors of the stomach. In: Bosman FT, Carneiro F, Hruban RH, Theise ND eds. World Health Organization Classification of Tumour: Pathology and Genetics of Tumours of the Digestive System. Lyon, France: IARC Press; 2010:79-80 p.
  • 2. Oda, Kondo H, Yamao T, Saito D, Ono H, Gotoda T, Yamaguchi H, Yoshida S, Shimoda T. Metastatic tumors to the stomach: Analysis of 54 patients diagnosed at endoscopy and 347 autopsy cases. Endoscopy. 2001;33:507-10.
  • 3. Green LK. Hematogenous metastases to the stomach. A review of 67 cases. Cancer. 1990;65:1596-600.
  • 4. Davis GH, Zollinger RW. Metastatic melanoma of the stomach. Am J Surg. 1960;99:94-6.
  • 5. Higgins PM. Pyloric obstructions due to a metastatic deposit from carcinoma of the bronchus. Can J Surg. 1962;5:438-41.
  • 6. Taal BG, Peterse H, Boot H. Clinical presentation, endoscopic features, and treatment of gastric metastases from breast carcinoma. Cancer. 2000;89:2214-21.
  • 7. Alpar S, Kurt OK, Ucar N, Orsel O, Aydog G, Kurt B. A case of squamous cell lung carcinoma with gastric metastasis. South Med J. 2006;99:1313-4.
  • 8. Campoli PM, Ejima FH, Cardoso DM, Silva OQ, Santana Filho JB, Queiroz Barreto PA, Machado MM, Mota ED, Araujo Filho JA, Alencar Rde C, Mota OM. Metastatic cancer to the stomach. Gastric Cancer. 2006;9:19-25.
  • 9. Raju U, Ma CK, Shaw A. Signet ring variant of lobular carcinoma of the breast: A clinicopathologic and immunohistochemical study. Mod Pathol. 1993;6:516-20.
  • 10. Harris M, Howell A, Chrissohou M, Swindell RI, Hudson M, Sellwood RA. A comparison of the metastatic pattern of infiltrating lobular carcinoma and infiltrating duct carcinoma of the breast. Br J Cancer. 1984;50:23-30.
  • 11. Cormier WJ, Gaffey TA, Welch JM, Welch JS, Edmonson JH. Linitis plastica caused by metastatic lobular carcinoma of the breast. Mayo Clin Proc. 1980;55:747-53.
  • 12. Hartmann WH, Sherlock P. Gastroduodenal metastases from carcinoma of the breast. An adrenal steroid-induced phenomenon. Cancer. 1961;14:426-31.
  • 13. Yoshida Y. Metastases and primary neoplasms of the stomach in patients with breast cancer. Am J Surg. 1973;125:738-43.
  • 14. Kobayashi T, Shibata K, Matsuda Y, Tominaga S, Komoike Y, Adachi S. A case of invasive lobular carcinoma of the breast first manifesting with duodenal obstruction. Breast Cancer. 2004;11:306-8.
  • 15. O’Connell FP, Wang HH, Odze RD. Utility of immunohistochemistry in distinguishing primary adenocarcinomas from metastatic breast carcinomas in the gastrointestinal tract. Arch Pathol Lab Med. 2005;129:338-47.
  • 16. Shimizu M, Matsumoto T, Hirokawa M, Shimozuma K, Manabe T. Gastric metastasis from breast cancer: A pitfall in gastric biopsy specimens. Pathol Int. 1998;48:240-1.
  • 17. Wang NP, Zee S, Zarbo RJ, Bacchi C, Gown A. Coordinate expression of cytokeratins 7 and 20 defines unique subsets of carcinomas. Appl Immunohistochem. 1995;3: 99-107
  • 18. Sangoi AR, Shrestha B, Yang G, Mego O, Beck AH. The novel marker GATA3 is significantly more sensitive than traditional markers mammaglobin and GCDFP15 for identifying breast cancer in surgical and cytology specimens of metastatic and matched primary tumors. Appl Immunohistochem Mol Morphol. 2016;24:229-37.
  • 19. Yang Y, Lu S, Zeng W, Xie S, Xiao S. GATA3 expression in clinically useful groups of breast carcinoma: A comparison with GCDFP15 and mammaglobin for identifying paired primary and metastatic tumors. Ann Diagn Pathol. 2017;26:1-5.
  • 20. Harrison JD, Morris DL, Ellis IO, Jones JA, Jackson I. The effect of tamoxifen and estrogen receptor status on survival in gastric carcinoma. Cancer. 1989;64:1007-10.
  • 21. Yokozaki H, Takekura N, Takanashi A, Tabuchi J, Haruta R, Tahara E. Estrogen receptors in gastric adenocarcinoma: A retrospective immunohistochemical analysis. Virchows Arch A Pathol Anat Histopathol. 1988;413:297-302.
  • 22. Chaubert P, Bouzourene H, Saraga E. Estrogen and progesterone receptors and pS2 and ERD5 antigens in gastric carcinomas from the European population. Mod Pathol. 1996;9:189-93.
  • 23. Guler ML, Daniels JA, Abraham SC, Montgomery EA. Expression of melanoma antigens in epithelioid gastrointestinal stromal tumors: A potential diagnostic pitfall. Arch Pathol Lab Med. 2008;132:1302-6.
  • 24. Dauplat J, Hacker NF, Nieberg RK, Berek JS, Rose TP, Sagae S. Distant metastases in epithelial ovarian carcinoma. Cancer. 1987;60:1561-6.
  • 25. Cormio G, Rossi C, Cazzolla A, Resta L, Loverro G, Greco P, Selvaggi L. Distant metastases in ovarian carcinoma. Int J Gynecol Cancer. 2003;13:125-9.
  • 26. Mizuguchi K, Minato H, Yoshida I, Iwadare J, Kayahashi K, Mitani Y, Watanabe K. Solitary gastric metastasis from a stage IA serous ovarian carcinoma: A case report with literature review. Intern Med. 2017;56:915-9.
  • 27. Burningham Z, Hashibe M, Spector L, Schiffman JD. The epidemiology of sarcoma. Clin Sarcoma Res. 2012;2:14.
  • 28. Lawrence W Jr, Donegan WL, Natarajan N, Mettlin C, Beart R, Winchester D. Adult soft tissue sarcomas. A pattern of care survey of the American College of Surgeons. Ann Surg. 1987;205:349- 59.
  • 29. Coindre JM, Terrier P, Guillou L, Le Doussal V, Collin F, Ranchère D, Sastre X, Vilain MO, Bonichon F, N’Guyen Bui B. Predictive value of grade for metastasis development in the main histologic types of adult soft tissue sarcomas: A study of 1240 patients from the French Federation of Cancer Centers Sarcoma Group. Cancer. 2001;91:1914-26.
  • 30. Levine EA. Prognostic factors in soft tissue sarcoma. Semin Surg Oncol. 1999;17:23-32.
  • 31. Akatsu Y, Saikawa Y, Kubota T, Kiyota T, Nakamura R, Akatsu T, Takahashi T, Yoshida M, Otani Y, Kumai K, Kitajima M. Metastatic gastric cancer from malignant fibrous histiocytoma: Report of a case. Surg Today. 2006;36:385-9.
  • 32. Dent LL, Cardona CY, Buchholz MC, Peebles R, Scott JD, Beech DJ, Ballard BR. Soft tissue sarcoma with metastasis to the stomach: A case report. World J Gastroenterol. 2010;16:5130-4. 33. Overberg-Schmidt US, Baumgarten E, Bassir C, Becker M, Unger M, Henze G. The stomach and pulmonary interlobular space as unusual sites of osteosarcoma. Pediatr Hematol Oncol. 1999;16:61-6.
  • 34. Strong VE, Shalkow J, Antonescu CR, Meyers P, La Quaglia MP. Osteosarcoma with delayed metastasis to the stomach. J Pediatr Surg. 2007;42:737-9.
  • 35. Horiuchi K, Susa M, Mukai M, Nishimoto K, Suzuki Y, Nakayama R, Hosaka S, Yabe H, Toyama Y, Morioka H. Osteosarcoma with metastasis to the stomach. J Orthop Sci. 2010;15:265-8.
  • 36. Urakawa H, Tsukushi S, Tsurudome I, Hirata A, Arai E, Kozawa E, Futamura N, Miyahara R, Ishiguro N, Nishida Y. Metastasis of osteosarcoma to stomach made clinically evident by hematemesis: A case report. World J Surg Oncol. 2013;11:48.
  • 37. Moses J, Gibson N, Plesec T, Plautz G, Kay M, Soldes O. Metastatic osteosarcoma to the stomach and ascending colon in a pediatric patient causing gastrointestinal hemorrhage. J Pediatr Surg. 2013;48:e1-3.
  • 38. Abe K, Seo K, Yagi M, Sasajima Y, Yagi T, Inaba T, Fukushima R. Gastrointestinal metastasis of cardiac leiomyosarcoma. Endoscopy. 2016;48:E349-E350.
  • 39. Costa M, Ivanova E, Esteves J. Upper gastrointestinal bleeding due to gastric metastasis from a primary uterine leiomyosarcoma. Acta Clin Belg. 2016;71:271-2.
  • 40. Nakajima Y, Kakizaki S, Kan da D, Shimada Y, Sohara N, Sato K, Takagi H, Mori M, Watanabe H. Pancreatic and gastric metastases of leiomyosarcoma arising in the left leg. Int J Clin Oncol. 2005;10:342-7.
  • 41. Ferrozzi F, Bova D, Garlaschi G. Gastric metastases from retroperitoneal leiomyosarcoma. Abdom Imaging. 1994;19:298- 300.
  • 42. Obata S, Mizutani J, Miura K, Kimura K, Maeda K, Fujioka Y, Matsumoto Y. Gastrointestinal metastases of an angiosarcoma. Endoscopy. 1993;25:438.
  • 43. Kim TO, Kim GH, Heo J, Kang DH, Song GA, Cho M. Metastasis of hepatic angiosarcoma to the stomach. J Gastroenterol. 2005;40:1003-4.
  • 44. Okabayashi K, Hanagiri T, Noda Y, Ozaki S, Shiraishi T, Mitsudomi T, Okamura T, Hamada T, Shirakusa T. Angiosarcoma of the chest wall with a gastric metastasis. Thorac Cardiovasc Surg. 1993;41:318-20.
  • 45. Konishi H, Isetani K, Satoh T, Fukuda S, Kodama T, Kashima K. A case of metastatic chondrosarcoma of the stomach. J Gastroenterol. 1994;29:495-500.
  • 46. Samuel T, Norly S, Ros’aini P. Gastric ulcer that turned out to be metastasis of a synovial sarcoma: A case report and literature review. Med J Malaysia. 2016;71:363-5.
  • 47. Choi DI, Chi HS, Lee SH, Kwon Y, Park SY, Sim SH, Park IH, Lee KS. A rare case of phyllodes tumor metastasis to the stomach presenting as anemia. Cancer Res Treat. 2017;49:846-9.
  • 48. Sonobe H, Taguchi K, Motoi M, Ogawa K, Matsumura M, Ohsaki K. Malignant fibrous histiocytoma of the maxillary sinus. Acta Pathol Jpn. 1980;30:79-89.
  • 49. Adams HW, Adkins JR, Rehak EM. Malignant fibrous histiocytoma presenting as a bleeding gastric ulcer. Am J Gastroenterol. 1983;78:212-3.
  • 50. Yasuda Y, Kosaba S, Hatakenaka R, Matsubara Y, Funatsu T, Ikeda S. A case report of primary malignant fibrous histiocytoma of the lung with metastasis to the stomach. Nihon Kyobu Geka Gakkai Zasshi. 1987;35:504-9.
  • 51. Fujii K, Matsushita T, Makino T. A case report of primary malignant fibrous histiocytoma of the lung with metastasis to the stomach (in Japanese). Iryo. 1993;47:224.
  • 52. Okada C, Nagao S, Tokunaga T, Sasaki J, Aono S, Fukushima Y. A case of the malignant fibrous histiocytoma with gastric involvement (in Japanese with English abstract). Gastroenterol Endosc. (Jpn Gastroenterol Endoscopy Soc) 1995;38:1648-53.
  • 53. Ohuchi T, Iwaki H, Ikeda T, Satoh M, Narimatsu H, Yasuhiko Y. A case of primary malignant fibrous histiocytoma of the ethmoidal sinus with metastasis to the gastric mucosa (in Japanese with English abstract). Gan no Rinsho. (Jpn J Cancer Clin) 1997;43: 255-61.
  • 54. Hisai H, Saitoh T, Sasaki H, Takahashi Y, Katahira T, Matsuyama T. A case of primary malignant fibrous histioctytoma of the knee with gastric metastasis (in Japanese with English abstract). Gastroenterol Endoscopy. (Jpn Gastroentelol Endoscopy Soc) 1998;40: 1034-9.
  • 55. Nishida T, Tanomichi D, Ogawa T, Koama K, Uesugi T, Morri K. A case of malignant fibrous histiocytoma with gastric metastasis (in Japanese). Nissekiigaku (Jpn Red Cross Med J). 1998;50:98. 56. Kato T, Kojima T, Shimizu T, Sasaki H, Abe M, Okushiba S, Kondo S, Kato H, Sato H. Inflammatory malignant fibrous histiocytoma of the gallbladder: Report of a case. Surg Today. 2002;32:81-5.
  • 57. Contreras Ibáñez JA, Navas García N, Díaz Gómez L. Mestastatic gastric cancer from malignant fibrous histiocytoma. Rev Esp Enferm Dig. 2011;103:44-6.
  • 58. Menuck LS, Amberg JR. Metastatic disease involving the stomach. Am J Dig Dis. 1975;20:903-13.
  • 59. Haendchen Bento L, Kazuyoshi Minata M, Pires Batista C, Martins BDC, Lenz Tolentino LH, Scomparim RC, Shiguehissa Kawaguti F, Gusmon de Oliveira CC, Simas de Lima M, Naschold Geiger S, Ryoka Baba E, Safatle-Ribeiro A, Ribeiro U Jr, Maluf- Filho F. Clinical and endoscopic aspects of metastases to the gastrointestinal tract. Endoscopy. 2019;51:646-52.
APA ALTAY A, BÜYÜK M, ÖZGÜR İ, GÖK A, Çavuş B, AYDIN SUDABATMAZ E, VATANSEVER S, Gulluoglu M (2021). Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. , 203 - 211. 10.5146/tjpath.2021.01529
Chicago ALTAY Ali Yılmaz,BÜYÜK Melek,ÖZGÜR İlker,GÖK Ali Fuat Kaan,Çavuş Bilger,AYDIN SUDABATMAZ ESRA,VATANSEVER Sezai,Gulluoglu Mine Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. (2021): 203 - 211. 10.5146/tjpath.2021.01529
MLA ALTAY Ali Yılmaz,BÜYÜK Melek,ÖZGÜR İlker,GÖK Ali Fuat Kaan,Çavuş Bilger,AYDIN SUDABATMAZ ESRA,VATANSEVER Sezai,Gulluoglu Mine Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. , 2021, ss.203 - 211. 10.5146/tjpath.2021.01529
AMA ALTAY A,BÜYÜK M,ÖZGÜR İ,GÖK A,Çavuş B,AYDIN SUDABATMAZ E,VATANSEVER S,Gulluoglu M Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. . 2021; 203 - 211. 10.5146/tjpath.2021.01529
Vancouver ALTAY A,BÜYÜK M,ÖZGÜR İ,GÖK A,Çavuş B,AYDIN SUDABATMAZ E,VATANSEVER S,Gulluoglu M Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. . 2021; 203 - 211. 10.5146/tjpath.2021.01529
IEEE ALTAY A,BÜYÜK M,ÖZGÜR İ,GÖK A,Çavuş B,AYDIN SUDABATMAZ E,VATANSEVER S,Gulluoglu M "Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries." , ss.203 - 211, 2021. 10.5146/tjpath.2021.01529
ISNAD ALTAY, Ali Yılmaz vd. "Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries". (2021), 203-211. https://doi.org/10.5146/tjpath.2021.01529
APA ALTAY A, BÜYÜK M, ÖZGÜR İ, GÖK A, Çavuş B, AYDIN SUDABATMAZ E, VATANSEVER S, Gulluoglu M (2021). Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. Türk Patoloji Dergisi, 37(3), 203 - 211. 10.5146/tjpath.2021.01529
Chicago ALTAY Ali Yılmaz,BÜYÜK Melek,ÖZGÜR İlker,GÖK Ali Fuat Kaan,Çavuş Bilger,AYDIN SUDABATMAZ ESRA,VATANSEVER Sezai,Gulluoglu Mine Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. Türk Patoloji Dergisi 37, no.3 (2021): 203 - 211. 10.5146/tjpath.2021.01529
MLA ALTAY Ali Yılmaz,BÜYÜK Melek,ÖZGÜR İlker,GÖK Ali Fuat Kaan,Çavuş Bilger,AYDIN SUDABATMAZ ESRA,VATANSEVER Sezai,Gulluoglu Mine Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. Türk Patoloji Dergisi, vol.37, no.3, 2021, ss.203 - 211. 10.5146/tjpath.2021.01529
AMA ALTAY A,BÜYÜK M,ÖZGÜR İ,GÖK A,Çavuş B,AYDIN SUDABATMAZ E,VATANSEVER S,Gulluoglu M Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. Türk Patoloji Dergisi. 2021; 37(3): 203 - 211. 10.5146/tjpath.2021.01529
Vancouver ALTAY A,BÜYÜK M,ÖZGÜR İ,GÖK A,Çavuş B,AYDIN SUDABATMAZ E,VATANSEVER S,Gulluoglu M Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries. Türk Patoloji Dergisi. 2021; 37(3): 203 - 211. 10.5146/tjpath.2021.01529
IEEE ALTAY A,BÜYÜK M,ÖZGÜR İ,GÖK A,Çavuş B,AYDIN SUDABATMAZ E,VATANSEVER S,Gulluoglu M "Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries." Türk Patoloji Dergisi, 37, ss.203 - 211, 2021. 10.5146/tjpath.2021.01529
ISNAD ALTAY, Ali Yılmaz vd. "Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries". Türk Patoloji Dergisi 37/3 (2021), 203-211. https://doi.org/10.5146/tjpath.2021.01529