A Resected Case of Uterine Metastasis after Curative Gastrectomy for Gastric Cancer

Abstract

Ovarian metastasis of gastric cancer is widely known as Krukenberg's tumor, whereas uterine metastasis from gastric cancer is rare. A resected case of uterine metastasis from gastric cancer to prevent bowel obstruction is presented. Computed tomography of a 72-year-old woman who underwent gastrectomy and adjuvant chemotherapy for advanced gastric cancer 6 years earlier showed rapid enlargement of her uterine fibroid and thickening of the rectal wall. On colonoscopy, an extrinsic rectal mass was seen, and histological examination of the biopsied specimen showed signet ring cell carcinoma. Although her cervical and endometrial smear cytology indicated no malignant findings, she was diagnosed as having metastatic tumors of the gastric cancer in her rectum and uterus. Laparotomy under general anesthesia showed the enlarged uterine fibroid and multiple peritoneal tumors in her jejunum, rectum, and mesentery. She underwent total hysterectomy with bilateral salpingo-oophorectomy and jejuno-jejunostomy to prevent bowel obstruction. Histological examination showed that signet ring cells were widely spreading in the stromal tissues of the uterine fibroid, uterine cervix, and uterine body. She received systemic chemotherapy and has been alive for 11 months after the second surgery.