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Gastric metastasis from small bowel adenocarcinoma in a Lynch syndrome patient

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Abstract

Gastric cancer is a Lynch syndrome (LS)-associated tumor, with the cumulative lifetime risk in LS patients estimated to be 5.8–13%. Hence, surveillance for gastric cancer is important for LS patients, especially in those with a family history of gastric cancer or of Asian descent. We report a very rare case of a LS patient who showed gastric metastasis from jejunal adenocarcinoma curatively resected 8 years prior. A 79-year-old female was diagnosed with a synchronous gastric submucosal tumor (SMT) and right-sided colon cancer. She was referred to our hospital as she and her family had histories of LS-associated tumors. She underwent curative intent surgery for the tumors. Postoperative histopathological examination revealed the gastric SMT was an adenocarcinoma completely covered by non-neoplastic gastric mucosa. Immunohistochemical analyses showed the gastric SMT had the same expression pattern for CDX2, cytokeratins 7 and 20 as the jejunal adenocarcinoma. Thirty-four months after surgery the patient is alive without recurrence or any other LS-associated tumors. To the best of our knowledge, this is the first report of gastric metastasis from small bowel adenocarcinoma in a LS patient. Awareness of this case may be important for gastric cancer surveillance in LS patients.

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Authors and Affiliations

  1. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 9518510, Japan

    Akio Matsumoto, Yoshifumi Shimada, Mae Nakano, Daisuke Yamai, Masato Nakano & Toshifumi Wakai

  2. Medical Genome Center, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan

    Yoshifumi Shimada, Mae Nakano & Toshifumi Wakai

  3. Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan

    Shuhei Kondo

  4. Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan

    Ken-ichi Mizuno

  5. Center for Medical Genetics, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan

    Hiromi Nyuzuki

  6. Division of Pathology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Japan

    Hajime Umezu

Authors
  1. Akio Matsumoto
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  2. Yoshifumi Shimada
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  3. Shuhei Kondo
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  4. Ken-ichi Mizuno
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  5. Mae Nakano
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  6. Daisuke Yamai
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  7. Masato Nakano
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  10. Toshifumi Wakai
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Contributions

All the authors made substantial contribution to the preparation of this manuscript and approved the final version for submission. AM and YS: drafted the manuscript; YS: corresponding author; SK, KM, MN, DY, MN, TH, and HN: clinical support; TW: careful review and final approve of the manuscript.

Corresponding author

Correspondence to Yoshifumi Shimada.

Ethics declarations

Ethics approval and consent to participate

The study was reviewed and approved by the Institutional Review Board of Niigata University (G2015-0816, G2020-0038).

Conflict of interest

The authors declare that they have no current financial arrangement or affiliation with any organization which may have a direct influence on their work.

Human and animal rights statement

This retrospective analysis was performed in accordance with the Helsinki Declaration, and the Ethics Committee of the School of Medicine, Niigata University approved the study protocol.

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Written informed consent was obtained from the patients for publication of these case reports and accompanying images.

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The authors declare that they have no current financial arrangement or affiliation with any organization which may have a direct influence on their work.

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Matsumoto, A., Shimada, Y., Kondo, S. et al. Gastric metastasis from small bowel adenocarcinoma in a Lynch syndrome patient. Clin J Gastroenterol 15, 575–581 (2022). https://doi.org/10.1007/s12328-022-01625-5

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  • DOI: https://doi.org/10.1007/s12328-022-01625-5

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