Cutaneous metastases from gastric adenocarcinoma 15 years after curative gastrectomy

Liu, Fang; Yan, Wen Liang; Liu, Haibo; Zhang, Min; Sang, Hong

doi:10.1590/abd1806-4841.20153829

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Case Report • An. bras. dermatol. 90 (3 suppl 1) • June 2015 • https://doi.org/10.1590/abd1806-4841.20153829 copy

Cutaneous metastases from gastric adenocarcinoma 15 years after curative gastrectomy^* * Work performed at the Department of Dermatology, Jinling Hospital affi liated to Nanjing University School of Medicine – Nanjing, China.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

We report the case of a 38-year-old man, who developed cutaneous metastases in the left inguinal groove 15 years after curative gastrectomy for advanced gastric adenocarcinoma. Histopathologic examination revealed poorly differentiated adenocarcinoma cells. They were stained positive for villin, CDX-2, CKpan (AE1/ AE3), CEA, CK8/18, CK19, CK7, EMA, Ki-67 (50%), and negative for S-100, CK20, CD34, GCDFP-15 and TTF-1. The patient underwent local excision, after the presence of other metastases was excluded. Nevertheless, local recurrence developed at the surgical bed one year later and PET/CT revealed metastases to lymph nodes, bone and skin. He died 2 years after the appearance of cutaneous metastases. We have reviewed the literature and described the immunohistochemical characteristics of cutaneous metastases from gastric adenocarcinoma.

Keywords:
Neoplasm metastasis; Skin neoplasms; Stomach neoplasms

Year of report and REFERENCES	Age/ gender	Duration of cutaneous metastases	Location	Immunohistochemical analysis		Outcome
Year of report and REFERENCES	Age/ gender	Duration of cutaneous metastases	Location	Cutaneous	Gastric	Outcome
2005⁷7 Früh M, Ruhstaller T, Neuweiler J, Cerny T. Resection of skin metastases from gastric carcinoma with long-term follow-up: an unusual clinical presentation. Onkologie. 2005;28:38-40.	60/M	2y	Face, scalp, right thigh	Positive for CK 1, 5, 10, 14, 7, 8, 18, 19, CEA, weakly positive for CK20, negative for CK13	Positive for CK 1, 5, 10, 14, 7, 8, 18, 19, CEA, weakly positive for CK20, negative for CK13	Death
2009¹1 Frey L, Vetter-Kauczok C, Gesierich A, Bröcker EB, Ugurel S. Cutaneous metastases as the first clinical sign of metastatic gastric carcinoma. J Dtsch Dermatol Ges. 2009;7:893-895.	54/M	First clinical manifestation	Scalp	Positive for CK20, CK7, MIB-1, Pancyto, negative for CDX2, TTF1,S-100	Positive for CK20, CK7, MIB-1, Pancyto, negative for CDX2, TTF1, S-100	Death
2014²2 Takata T, Takahashi A, Tarutani M, Sano S. A rare case of cellulitis-like cutaneous metastasis of gastric adenocarcinoma. Int J Dermatol. 2014;53:e122-4.	61/M	8y	Left groin and thigh	Positive for CK7, partially positive for CK20, negative for S100 and LCA	Not performed	Death
2010⁸8 Aneiros-Fernandez J, Husein-ElAhmed H, Arias-Santiago S, Escobar Gómez-Villalva F, Nicolae A, O'Valle Ravassa F, et al. Cutaneous metastasis as first clinical manifestation of signet ring cell gastric carcinoma. Dermatol Online J. 2010;16:9.	69/M	First clinical manifestation	Chest	Positive for AE1/AE3, CK20, CK18, negativity for GCDFP-15, CK7, S-100, HMB-45, MELAN A, CD45	Not performed	Death
2010⁵5 Karakoca Y, Aslan C, Erdemir AT, Kiremitci U, Gurel MS, Huten O. Neurofibroma like nodules on shoulder: First sign of gastric adenocarcinoma. Dermatol Online J. 2010;16:12.	68/F	3 year history of gastric ulcer	Neck	Positive for CK7, negative for CK20	Not performed	Not mentioned
2008⁹9 Hayashi K, Yamamoto T, Oyama K, Nagai T, Tsuboi R. Epidermotropic skin metastasis from gastric cancer: immunohistochemical analysis using cytokeratins. Clin Exp Dermatol. 2009;34:406-8	61/M	First clinical manifestation	Neck	Positive for CK7, CEA, negative for CK20	Positive for CK7, CEA, negative for CK20	Not mentioned
2005⁶6 Lifshitz OH, Berlin JM, Taylor JS, Bergfeld WF. Metastatic gastric adenocarcinoma presenting as an enlarging plaque on the scalp. Cutis. 2005;76:194-6.	73/M	3.5y	Scalp and upper forehead.	Positive for AE1/AE3	Not performed	Death
2008¹⁰10 Xavier MH, Vergueiro Tde R, Vilar EG, Pinto JM, Issa MC, Pereira GB, et al. Cutaneous metastasis of gastric adenocarcinoma: an exuberant and unusual clinical presentation. Dermatol Online J. 2008;14:8.	48/M	First clinical manifestation	Lower abdomen, thorax, left side, arms, face	Positive for EMA, CEA, AE1 /AE3, TTF-1, negative for S-100, CK20, CK7, HHF-35, AML	Not performed	Deterioration
Present case	38/M	15y	Left inguinal groove	Positive for villin, CDX-2, CKpan, CEA, CK8/18, CK19, CK7, EMA, Ki67(50%), negative for S-100, CK20, CD34, GCDFP-15, TTF-1	Not performed	Death

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[1] MAILING ADDRESS: Hong Sang, Department of Dermatology, Jinling Hospital affi liated to Nanjing University school of Medicine, Nanjing, 210002 China. E-mail:sanghong@nju.edu.cn.

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Cutaneous metastases from gastric adenocarcinoma 15 years after curative gastrectomy* * Work performed at the Department of Dermatology, Jinling Hospital affi liated to Nanjing University School of Medicine – Nanjing, China.

Abstract

Cutaneous metastases from gastric adenocarcinoma 15 years after curative gastrectomy^* * Work performed at the Department of Dermatology, Jinling Hospital affi liated to Nanjing University School of Medicine – Nanjing, China.