Metachronous Colonic Metastasis from Gastric Adenocarcinoma presenting 13 Years after Gastrectomy: A Case Report and Review of the Literature

Hiroyuki Shiokawa, Kimihiko Funahashi, Junichi Koike, Naoyasu Saito, Akiharu Kurihara, Tomoaki Kaneko, Kentaro Shirasaka, Tomohiko Goto, Kazutoshi Shibuya* and Tatsuo Teramoto

Department of Gastroenterological Surgery and Department of Pathology*, Toho Medical Center Omori Hospital

We report a rare case of metastatic colon cancer which occurred 13 years after gastric cancer surgery. A 69-year-old woman visited our hospital with complaint of postprandial abdominal discomfort. We suspected colon cancer with primary diffuse invasion to the transverse or metastatic colon cancer from barium enema and colonoscopy. Postoperative histological examination identified poorly differentiated adenocarcinoma identical to the gastric cancer that the woman had 13 years earlier. Finally, the lesion was definitively diagnosed as metastatic colon cancer from gastric cancer by immunohistological findings, that showed same pattern in mucin phenotype. We studied 54 cases (73 lesions) in reports in the literature from 2001 to 2006. Histologically, metastatic colon cancer from the gastric cancer often involved signet ring cell carcinoma or poorly differentiated adenocarcinoma. In 46.3% of cases (25 cases), metastasis was detected 5 years or more after surgery. In fatal cases following reoperation, mean survival was 16.6 months. Survival time was independent of the time to metastasis detection, and tumor markers were not effective in prediction.

Key words
metastatic colon cancer, gastric cancer, poorly differentiated adenocarcinoma

Reprint requests
Kimihiko Funahashi Department of Gastroenterological Surgery, Toho Medical Center Omori Hospital
6-11-1 Omori-nishi, Ota-ku, 143-8541 JAPAN

Accepted
May 21, 2008

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