Cutaneous metastases from gastric adenocarcinoma 15 years after curative gastrectomy

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.

FIGURE 1

Multiple, reddish-colored, fi xed nodules, measuring between 0.5 and 3cm in diameter in the left inguinal groove area

FIGURE 2

Histopathological examination revealed that tumor cells had hyperchromatic nuclei, numerous mitoses and prominent ductal formation, consistent with adenocarcinoma, and tumor nests extended from the epidermis into the dermis. (A HE×100, B HE×400)

FIGURE 3

Immunohistochemistry of cutaneous metastasis from gastric adenocarcinoma. (100×): (A) CDX-2, (B) CKpan, (C) CK19, (D) CD8/18, (E) CK7, (F) EMA, (G) villin, (H) Ki-67, (I) CKpan (J) CEA