A Case of Gastric Carcinoma with a Metastasis to the Tongue

Kazuo Yasumoto, Kouichi Hirano and Atsuhiro Kawashima^*

Depertment of Surgery, Toyama Post and Telecommunication Hospital
^*1st Depertment of Pathology, Kanazawa University School of Medicine

An extremely rare case of gastric carcinoma with metastasis to the tongue is reported. A 65-year-old man had undergone total gastrectomy for a type 3 gastric carcinoma, which was located in the upper portion of the stomach (P₀H₀t₂n₁, Stage II, D₂), about one year before. Histopathologically, the resected specimen contained moderately differentiated tubular adenocarcinoma (ss, ly₀,v₂). Following gastrectomy, he was admitted to our hospital complaining of one subcutaneous tumor over the right middle abdomen. Serum CA19-9 was also elevated. Two months after the admission, physical examination showed a swollen tumor in the left side of the tongue. A biopsy of the tongue tumor indicated adenocarcinoma which was strikingly similar to the primary gastric cancer. In addition, all specimens of these tumors were positive for CA19-9 staining. Therefore, these two tumors of the tongue and the skin were diagnosed as metastases of the gastric carcinoma. Interestingly, he had developed no metastases other than the tongue, the skin and the lymph node. Furthermore, histochemical analysis showed that overexpression of mutant p53 protein was detected in both tissue from the most progressive site of the primary and from the metastatic tumors, suggesting that alteration of the p53 gene may be involved in the progression of gastric cancer.

Key words
gastric cancer, metastasis to the tongue, metastasis to the skin

Reprint requests
Kazuo Yasumoto Department of Surgery, Toyama Post and Telecommunication Hospital 2-2-29 Kashima-cho, Toyama, 930-8798 JAPAN

Accepted
March 31, 1999

To read the PDF file you will need Abobe Reader installed on your computer.