A Case of Metastatic Gastric Cancer from Rectal Cancer

Ryutaro Sakabe, Naoki Hirabayashi, Yukio Sato, Wataru Takiyama, Minoru Kameoka, Akira Nakashima, Masaki Kuwahara, Shuji Saeki, Hidenori Mukaida and Yoshinori Yamashita

Department of Surgery, Hiroshima City Asa Hospital

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.

Key words
metastatic gastric cancer, rectal cancer, bull's eye sign

Reprint requests
Ryutaro Sakabe Department of Surgery, Hiroshima City Asa Hospital
2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293 JAPAN

Accepted
October 25, 2006

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