Abdominal parietal metastasis on operative scar of gastric adenocarcinoma after R0 resection: An unusual location (about a case).

Abstract

Introduction: Gastric cancer is the fifth most common cancer in Ivory Coast, and is the third cause of cancer death. Parietal metastasis is extremely rare and are distinguished by their relatively poor prognosis with a median survival not exceeding 7 months.

Observation: We report the case of a 73-year-old male patient who presented 5 months after a partial R0 lower polar gastrectomy for gastric adenocarcinoma, a single cutaneous metastasis at the level of the laparotomy incision. The histology of this metastasis was an adenocarcinoma. Multidisciplinary consultation meeting, palliative chemotherapy and metastasis surgery was proposed but with the rapid progression of the tumor disease the patient died 3 months after the diagnosis of the metastasis.

Discussion: Gastric cancer is the fifth most common cancer in Ivory Coast, and is the third cause of cancer death. The most common metastases in patients are the liver, peritoneum and lungs. Parietal metastasis are rare and their frequency is estimated at 4 % in visceral cancers. Anterior abdominal wall metastases have mainly been associated with surgical incision, whether by laparotomy or laparoscopy. Clinical representation is often in the form of dermal or hypodermal nodules of variable size and generally limited number, rapid growth. The diagnosis is made either by carrying out a biopsy or by anatomopathological examination of the surgical specimen. The management is palliative. The prognosis for parietal metastasis is often poor.

Conclusion: Parietal metastasis has a poor prognosis and should always be considered in the face of skin lesions in patients with a history of cancer.