Metachronous Schnitzler's Metastasis of Gastric Adenocarcinoma 13 Years After Curative Resection: A Case Report.

Jun Kyeong Lim, Suk Bae Kim, Hyun Deok Shin
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Abstract

A 54-year-old man presented with constipation with a six-month duration and a 5 kg weight loss over 10 months. He had undergone a subtotal gastrectomy and chemotherapy for advanced gastric cancer 13 years earlier. A colonoscopy revealed a firm, circular, in-growing mass in the rectum. A computed tomography (CT) scan showed a 3.0×1.2 cm invasive mass near the prostate, abutting the rectal wall and invading the right ureterovesical junction, causing hydroureteronephrosis. A positron emission tomography-CT scan indicated low fluorodeoxyglucose uptake in the rectal or prostate area. The biopsy results showed poorly differentiated carcinoma. An immunohistochemistry study confirmed CK7 positive, CK20 negative, MUC2 negative, and CDX2 focally positive immune phenotype for cancer cells, suggesting a diagnosis of metastatic adenocarcinoma with a gastric origin rather than a prostate and rectal origin.

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胃癌根治切除13年后异时性Schnitzler转移1例。
54岁男性,便秘6个月,10个月体重减轻5公斤。13年前,他因晚期胃癌接受了胃大部切除术和化疗。结肠镜检查发现直肠内有一个坚固的圆形生长肿块。计算机断层扫描(CT)显示一个3.0×1.2厘米的浸润性肿块靠近前列腺,毗邻直肠壁,侵犯右侧输尿管膀胱交界处,引起肾盂积水。正电子发射断层扫描- ct扫描显示低氟脱氧葡萄糖摄取在直肠或前列腺区域。活检结果为低分化癌。一项免疫组织化学研究证实癌细胞的免疫表型为CK7阳性、CK20阴性、MUC2阴性和CDX2局灶阳性,提示转移性腺癌的诊断为胃起源,而不是前列腺和直肠起源。
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