A case of synchronous gastric metastasis from sigmoid colon cancer

초록

Colorectal cancer is the second and third most common cancer in Korea and the world, respectively. Approximately 20% of patients with colorectal cancer already have metastases at initial diagnosis. The liver (50%) and lungs (10-15%) are the most commonly involved sites of metastasis from colorectal cancer. Metastatic gastric cancer is rare with the most common primary sites include melanoma, breast and lung cancer. In one large-scale autopsy study, only 0.8% of colon cancer metastasized to the stomach. Herein, we report an interesting case of synchronous metastatic involvement of stomach secondary to sigmoid colon cancer. A 78-year-old male with past medical history of Alzheimer’s disease carried out upper and lower endoscopy for routine health examination. The duodenoscopy revealed a 3.0 x 2.0 cm sized ulcerofungating mass in the lesser curvature side of mid gastric antrum, and a colonoscopy showed a 2.0 x 4.0 cm sized ulcerofungating mass in the distal sigmoid, locating 16 cm from the anal verge. The pathological examination of the endoscopic biopsy specimens obtained from stomach and sigmoid colon indicated well-differentiated adenocarcinoma, which showed similar histologic characteristics with each other. An abdominal and pelvic computed tomography scan revealed a tumor involving antrum to pylorus, with perigastric infiltration and a second mass 5.5 cm in size at the distal sigmoid colon. Consequently, he underwent radical subtotal gastrectomy and anterior resection simultaneously.