Atypical Presentation of Gastric Adenocarcinoma Metastasis: Case Report

Authors:
Luiz Carlos Furtado de ALMEIDA JUNIOR¹, Guilherme Freire Angotti CARRARA¹, Maria Eduarda Paracini SOARES¹, Maria Nathália Vilela ASSIS², Anna Flávia de Almeida ALVES¹, Douglas Reis ABDALLA³


Affliations:
¹University of Uberaba, Uberaba, Minas Gerais, Brazil
²Department of General Surgery, Medical Faculty of São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
³Health Courses of the Faculty of Human Talents, Uberaba, Minas Gerais, Brazil


Corresponding email address:
Luiz Carlos Furtado de ALMEIDA JUNIOR (luiz.almeida@uniube.br)

Introduction: Gastric cancer is the 5th most common cancer, except for non-melanoma skin tumors, and the 3rd leading cause of death from cancer worldwide. The most common sites of metastases from gastric cancer are liver (48%), peritoneum (32%), lung (15%) and bone (12%). Skin metastases from visceral neoplasms are relatively rare, with an incidence rate of about 5%, so that these metastases account for about 2% of all skin cancers reported.

Aim: To present the course of cutaneous metastasis as a result of gastric adenocarcinoma.

Methods: Descriptive study of the case report type, whose data were obtained from the patient's physical records.

Case presentation: We report the case of a 44-year-old female patient who underwent surgical and chemotherapy treatment for gastric adenocarcinoma. One year and four months after the initial intervention, the appearance of hyperchromic, painful, diffuse, non-pruritic skin lesions was observed, mainly located on the chest, back and upper limbs. Skin biopsy confirmed the hypothesis of cutaneous metastasis from gastric adenocarcinoma. After the diagnosis of skin metastasis, the cycle of chemotherapy with Anthracycline was stopped and replaced with Paclitaxel associated with Ramucirumab. One month after starting the new chemotherapies, there was a reduction of skin lesions. However, even after the improvement of the skin presentation, the patient presented progression of the peritoneal and ovarian disease, with loss of performance status, without conditions for a new line of treatment. However, she did not have any recurrence or appearance of new skin lesions.

Conclusion: In the context of gastric cancer treatment, it is important to watch for new signs and symptoms, such as insidious skin lesions, suggesting the possibility of metastatic skin tumor.

Keywords: Gastric Cancer; Metastasis; Adenocarcinomas.

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