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2013 | 85 | 7 | 401-406
Tytuł artykułu

Brain metastasis as the first symptom of gastric cancer – case report and literature review

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
The study presented a patient with asymptomatic gastric cancer, in whom the first symptom was metastasis to the brain. The patient was initially diagnosed by a neurologist and subject to surgical intervention in the area of residence, where he underwent craniotomy with the excision of the metastatic lesions located in the occipital lobe. The histopathological examination revealed the presence of adenocarcinoma metastases. Following complex diagnostics the patient was diagnosed with cardial carcinoma, being subject to cerebral radiotherapy and chemotherapy. The patient was then referred to surgery at the Wielkopolska Cancer Center in Poznań. After final exclusion of disease dissemination (by means of PET-CT) the patient underwent total gastrectomy with D2 lymphadenectomy, and gastrointestinal tract reconstruction by means of the Roux-en-Y method. The histopathological examination result was as follows: tubular-papillary G2 adenocarcinoma (intestinal type), pT2 pN0 (23 evaluated lymph nodes without cancer metastasis), vascular neoplastic emboli, and positive HER2 protein expression. After surgery the patient was subject to adjuvant chemotherapy. Control brain CT examinations revealed the presence of 4 recurrent metastatic lesions-the patient was disqualified from stereotactic radiation therapy and was subject to palliative chemotherapy. The discussion presented the problem of treating patients with stage IV gastric cancer, including current management guidelines, as well as literature review concerning the treatment of patients with diagnosed gastric cancer and brain metastases.
Wydawca

Rocznik
Tom
85
Numer
7
Strony
401-406
Opis fizyczny
Daty
wydano
2013-07-01
online
2013-08-13
Twórcy
autor
  • 1st Clinic of Surgical Oncology and General Surgery, Wielkopolska Cancer Center in Poznań, Ordynator: prof. dr hab. P. Murawa
  • 1st Clinic of Surgical Oncology and General Surgery, Wielkopolska Cancer Center in Poznań, Ordynator: prof. dr hab. P. Murawa, piotr_nowaczyk@o2.pl
  • 61-866 Poznań, ul. Garbary 15
  • Student Research Group of Surgical Oncology and General Surgery at the 1st Clinic of Surgical Oncology and General Surgery, Wielkopolska Cancer Center in Poznań, Opiekunowie: dr hab. D. Murawa, lek. P. Nowaczyk
  • Department of Oncology, Subdepartment of Hematology, Regional Hospital in Konin, Ordynator: lek. B. Karaszewska
Bibliografia
  • 1. Zalecenia diagnostyczno-terapeutyczne w nowotworach złośliwych 2009. Nowotwory żołądka. Polska Unia Onkologii.
  • 2. Globocan 2008 (http://globocan.iarc.fr/factsheet.asp).
  • 3. Krajowa baza nowotworów (http://85.128.14.124/krn/) .
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  • 5. D’Angelica M, Gonen M, Brennan MF et al.: Patterns of initial recurrence in completely resected gastric carcinoma. Ann Surg 2004; 240: 808-16.[PubMed]
  • 6. Olesiński T, Jeziorski K, Szawłowski A: Przerzuty do opon mózgowo-rdzeniowych w przebiegu gruczolakoraka połączenia przełykowo-żołądkowo - opis przypadku i przegląd możliwości leczenia. Współ Onkol 2007; 11: 252-56.
  • 7. York JE, Stringer J, Ajani JA et al.: Gastric cancer and metastasis to the brain. Ann Surg Oncol 1999; 6:771-76.[PubMed][Crossref]
  • 8. Go PH, Klaassen Z, Meadows MC et al.: Gastrointestinal Cancer and Brain Metastasis: a rare and ominous sign. Cancer 2011; 117: 3630-40.[WoS][PubMed][Crossref]
  • 9. Kasakura Y, Fujii M, Mochizuki F et al.: Clinicopathological study of Brain Metastasis in Gastric Cancer Patients. Surg Today 2000; 30: 485-90.[Crossref][PubMed]
  • 10. Murawa D, Połom K, Murawa P: Problem leczenia przerzutu raka jelita grubego do mózgowiaopis przypadku. Pol Przegl Chir 2005; 77: 488-95.
  • 11. Nomura T, Yoshikawa T, Kato H: Early gastric cancer manifested as brain metastasis: report of a case. Surg Today 1997; 27: 334-36.[PubMed][Crossref]
  • 12. Perri F, Bisceglia M, Giannatempo GM et al.: Cerebellar Metastasis as Unique Presenting Feature of Gastric Cancer. J Clin Gastroenterol 2001; 33: 80-81.[Crossref][PubMed]
  • 13. Bang YJ, Van Cutsem E, Feyereislova A et al.: Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2- positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 2010;376: 687-97.[WoS][Crossref]
  • 14. Oñate-Ocaña LF, Méndez-Cruz G, Hernández-Ramos R et al.: Experience of surgical morbidity after palliative surgery in patients with gastric carcinoma. Gastric Cancer 2007;10: 215-20.[Crossref][WoS]
  • 15. Kahlke V, Bestmann B, Schmid A et al.: Palliation of metastatic gastric cancer: impact of preoperative symptoms and the type of operation on survival and quality of life. World J Surg 2004;28: 369-75.[PubMed][Crossref]
  • 16. Chang YR , Han DS , Kong SH et al.: The value of palliative gastrectomy in gastric cancer with distant metastasis. Ann Surg Oncol 2012;19: 1231-39.[Crossref][PubMed]
  • 17. Sougioultzis S, Syrios J, Xynos ID et al.: Palliative gastrectomy and other factors affecting overall survival in stage IV gastric adenocarcinoma patients receiving chemotherapy: a retrospective analysis. Eur J Surg Oncol 2011; 37: 312-18.[WoS][PubMed][Crossref]
  • 18. Koga R, Yamamoto J, Ohyama S et al.: Liver resection for metastatic gastric cancer: experience with 42 patients including eight long-term survivors. Jpn J Clin Oncol 2007; 37: 836-42.[Crossref]
  • 19. Chee CP, Byrnes DP: Cases of brain metastasis presenting as the first sign of systemic cancer. SingMed J 1988; 29: 252-56.[PubMed]
  • 20. Sze G, Milano E, Johnson C et al.: Detection of brain metastases: comparison of contrast-enhanced MR with unenhanced MR and enhanced CT. AJNRAm J Neuroradiol. 1990; 11: 785-91.[PubMed]
  • 21. Bartelt S, Momm F, Weissenberger C et al.: Patients with brain metastases from gastrointestinal tract cancer treated with whole brain radiation therapy: prognostic factors and survival. World JGastroenterology 2004; 10: 3345-48.
  • 22. Breaux JR, Bringaze W, Chappuis C et al.: Adenocarcinoma of the stomach: a review of 35 years and 1710 cases. World J Surg 1990; 14: 580-86.
  • 23. Rohde H, Bauer P, Stützer H, Heitmann K et al.: Proximal compared with distal adenocarcinoma of the stomach: differences and consequences. German Gastric Cancer TNM Study Group. Br J Surg 1991; 78: 1242-48.
  • 24. Nussbaum ES , Djalilian HR, Cho KH et al.: Brain metastases, histology, multiplicity, surgery and survival. Cancer 1999; 78: 1781-88.
  • 25. Lee S, Rha S, Kim Y et al.: Brain metastasis of advanced gastric cancer is not hopeless: A retrospective, single-institutional study of long term follow-up in Korea. J Clin Oncol 26: 2008 (May 20 suppl; abstr 15668).
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2013-0061
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