A Case of Early Gastric Cancer with Nodular Tumor-like Scalp Metastasis

Young Wook Song; Woo Sub Kim; Gee Young Yun; Sun Wook Park; Sun Hyung Kang; Hee Seok Moon; Jae Kyu Sung; Hyun Yong Jeong

doi:10.4166/kjg.2016.68.1.36

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Song, Kim, Yun, Park, Kang, Moon, Sung, and Jeong: A Case of Early Gastric Cancer with Nodular Tumor-like Scalp Metastasis

Case Report

Korean J Gastroenterol 2016;68(1):36-39.

Published online: 4 October 2016

DOI: https://doi.org/10.4166/kjg.2016.68.1.36

A Case of Early Gastric Cancer with Nodular Tumor-like Scalp Metastasis

Young Wook Song, Woo Sub Kim¹, Gee Young Yun¹, Sun Wook Park, Sun Hyung Kang¹, Hee Seok Moon¹, Jae Kyu Sung¹, Hyun Yong Jeong¹

Division of Gastroenterology, Daejeon Veterans Hospital, Daejeon, Korea

¹Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea

Correspondence to: Hee Seok Moon, Department of Internal Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. Tel: +82-42-280-7142, Fax: +82-42-257-5753, E-mail: mhs1357@cnuh.co.kr

Received 22 March 2016 Revised 26 April 2016 Accepted 6 May 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Many neoplasms, including lung cancer, breast cancer, melanoma, and gastrointestinal tract malignancy, possess potential for skin metastasis. Skin metastases can represent the first presentation of such malignancies and may be observed incidentally during routine exam. Skin metastases from gastric adenocarcinoma are uncommon, with a prevalence rate of 0.04–0.8%. Cutaneous metastases from gastric cancer are generally observed as the initial symptom of advanced gastric cancer. Early detection and treatment can increase patient survival. A 42-year-old woman visited our department with nodule about 1 cm in size on the right frontal scalp noticed incidentally after laparoscopy-assisted distal gastrectomy and adjuvant systemic chemotherapy for early gastric cancer about 16 months prior. The patient was diagnosed with skin metastasis from gastric adenocarcinoma. Complete excision of the skin lesion and additional chemotherapy were performed. Herein, we report a case of nodular tumor-like scalp metastasis from early gastric cancer with a brief review of the literature.

Keywords: Stomach neoplasms, Neoplasm metastasis, Scalp

References

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Fig. 1.

Upper endoscopic finding taken in its initial presentation. Endoscopy shows a reddish lesion, about 2 cm, with irregular surface and central shallow depression on the gastric antrum.

Fig. 2.

Resected stomach pathologic findings. (A) The arrow indicates gross finding at early gastric cancer site. (B) Poorly differentiated tubular adenocarcinoma have invaded the submucosal layer, above 500 μm (H&E, ×100).

Fig. 3.

Gross appearance. Photograph shows an erythematous hard tumor of about 1 cm on the right frontal scalp.

Fig. 4.

Microscopic findings of the scalp biopsy. (A) Infiltrative malignant cells are seen in the dermis, consistent with metastatic adenocarcinoma (H&E, ×200). Immunohistochemical staining for cytokeratin shows diffuse malignant cell infiltration (×200).

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