2007 Volume 40 Issue 5 Pages 677-682
Metastatic gastric cancer from colorectal cancer is rare, with only 18 cases reported, to our knowledge, in Japan. We report a case of gastric cancer metastatic from rectal cancer. A 53-year-old man, who previously underwent abdominoperineal resection for rectal cancer 14 months earlier, was found in gastric endoscopy to have multiple small gastric nodules. Most of the nodules appeared to be submucosal tumors with deep ulceration at the center. Upper gastrointestinal barium radiography showed a so-called bull.s eye sign. Microscopic findings of biopsy specimens of nodules showed mucinous adenocarcinoma accompanied by signet ring cell carcinoma, similar to the primary rectal cancer. He was diagnosed with gastric cancer metastatic from rectal cancer. He underwent systemic chemotherapy but died of cancer progression 5 months after the diagnosis of metastatic gastric cancer (19 months after primary surgery). Autopsy showed multiple metastases at the stomach, small intestine, colon, lung, liver, and bone marrow. Microscopic findings of the gastric tumors showed mucinous adenocarcinoma and signet ring cell carcinoma mainly presented in the submucosal and muscle layer, confirming that gastric tumors had hematogenically metastasized from rectal cancer.
