Kim MJ, Hong JH, Park ES, Byun JH. Gastric metastasis from primary lung adenocarcinoma mimicking primary gastric cancer. World J Gastrointest Oncol 2015; 7(3): 12-16 [PMID: 25780510 DOI: 10.4251/wjgo.v7.i3.12]
Corresponding Author of This Article
Jae Ho Byun, MD, PhD, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56, Dongsu-Ro, Bupyeong-Gu, Incheon 403-720, South Korea. jhbyun37@catholic.ac.kr
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Mar 15, 2015; 7(3): 12-16 Published online Mar 15, 2015. doi: 10.4251/wjgo.v7.i3.12
Gastric metastasis from primary lung adenocarcinoma mimicking primary gastric cancer
Min Ji Kim, Ji Hyung Hong, Eun Su Park, Jae Ho Byun
Min Ji Kim, Ji Hyung Hong, Jae Ho Byun, Department of Internal Medicine, Incheon St. Mary¡¯s Hospital, College of Medicine, The Catholic University of Korea, Bupyeong-Gu 403-720, South Korea
Ji Hyung Hong, Jae Ho Byun, Division of Medical Oncology, Department of Internal Medicine, Incheon St. Mary¡¯s Hospital, College of Medicine, The Catholic University of Korea, Bupyeong-Gu 403-720, South Korea
Eun Su Park, Department of Hospital Pathology, Incheon St. Mary¡¯s Hospital, College of Medicine, The Catholic University of Korea, Bupyeong-Gu 403-720, South Korea
Author contributions: Kim MJ and Hong JH collected the data and wrote the initial manuscript equally; Hong JH edited the manuscript; Park ES gave pathology opinion and prepared the slides for publication; Byun JH did critical editing.
Ethics approval: The study was reviewed and approved by the Incheon St. Mary’s Hospital Institutional Review Board.
Informed consent: Informed consent was waived because of retrospective characteristic of this report.
Conflict-of-interest: None of the authors has any conflict of interest or financial disclosures to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jae Ho Byun, MD, PhD, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56, Dongsu-Ro, Bupyeong-Gu, Incheon 403-720, South Korea. jhbyun37@catholic.ac.kr
Telephone: +82-32-2805857 Fax: +82-32-2806100
Received: September 28, 2014 Peer-review started: September 29, 2014 First decision: January 8, 2015 Revised: February 25, 2015 Accepted: March 5, 2015 Article in press: March 6, 2015 Published online: March 15, 2015 Processing time: 165 Days and 19.1 Hours
Abstract
Gastric metastases from lung adenocarcinoma are rare. Because gastric metastasis grossly resembles advanced gastric cancer, it is difficult to diagnose gastric metastasis especially when the histology of the primary lung cancer is adenocarcinoma. We describe a case of gastric metastasis from primary lung adenocarcinoma mimicking Borrmann type IV primary gastric cancer. A 68-year-old man with known lung adenocarcinoma with multiple bone metastases had been experiencing progressive epigastric pain and dyspepsia over one year. Esophagogastroduodenoscopy revealed linitis plastica-like lesions in the fundus of the stomach. Pathologic examination revealed a moderately differentiated adenocarcinoma with submucosal infiltration. Positive immunohistochemical staining for thyroid transcription factor-1 (TTF-1) and napsin A (Nap-A) confirmed that the metastasis was pulmonary in origin. The patient had been treated with palliative chemotherapy for the lung cancer and had lived for over fifteen months after the diagnosis of gastric metastasis. Clinicians should be aware of the possibility of gastric metastasis in patients with primary lung adenocarcinoma, and additional immunohistochemical staining for Nap-A as well as TTF-1 may help in differentiating its origin.
Core tip: This report describes the rare case of a 68-year-old patient with gastric metastasis from primary lung adenocarcinoma mimicking Borrmann type IV primary gastric cancer. When gastric carcinoma is suspected in patients with primary lung adenocarcinoma, a differential diagnosis of primary gastric cancer and gastric metastasis can be done through special immunohistochemical staining with napsin-A and thyroid transcription factor-1, especially when the biopsy results are ambiguous by histology alone.
