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Erschienen in: European Surgery 4/2016

01.08.2016 | case report

Gastric carcinoma presenting with severe rectal stenosis: ‘Schnitzler’s metastasis’: case report and review of the literature

verfasst von: Z. S. Derici, MD, S. Sokmen, MD. FACS FASCRS(Int’l) FASPSM Prof. of Surgery

Erschienen in: European Surgery | Ausgabe 4/2016

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Abstract

Background

Distant metastasis of primary gastric carcinoma may occur via venous, lymphatic spread and/or peritoneal seeding. Herein we report on an atypical presentation of clinical, endoscopic, and radiologic features of metastatic gastric adenocarcinoma with symptoms mainly due to rectal carcinomatous involvement.

Methods

Case report and review of the literature

Results

We presented the case of 39-year-old-woman with a clinical history of 6 months of dyspepsia, abdominal discomfort, and constipation, who was admitted to hospital with a full-blown picture of mechanical bowel obstruction. These symptoms occurred owing to secondary linitis plastica of the rectum. An extended Hartmann procedure was performed, and the patient was referred to systemic chemotherapy. The overall survival was 5.5 months. The symptoms, findings, preoperative management, and treatment choices are discussed with a review of published cases of Schintzler’s metastasis.

Conclusion

Gastric linitis plastica is the most common cause of secondary neoplastic infiltration of the colon. An unusual case of Schnitzler’s metastasis to the rectum, synchronously or metachronously, should occur from diffuse type signet-ring cell gastric carcinoma. The clinical findings of severe rectal stenosis with a poorly differentiated gastric adenocarcinoma must call attention to the entity of rectal Schnitzler’s metastasis.
Literatur
1.
Zurück zum Zitat Rausei S, Frattini F, Dionigi G, Boni L, Rovera F, Diurni M. Unusual rectal stenosis. Journal of Surgical Oncology. 2010;102:713–713.CrossRefPubMed Rausei S, Frattini F, Dionigi G, Boni L, Rovera F, Diurni M. Unusual rectal stenosis. Journal of Surgical Oncology. 2010;102:713–713.CrossRefPubMed
2.
Zurück zum Zitat Lim SW, Huh JW, Kim YJ, Kim HR. Laparoscopic low anterior resection for hematogenous rectal metastasis from gastric adenocarcinoma: A case report. World Journal of Surgical Oncology. 2011;9:148CrossRefPubMedPubMedCentral Lim SW, Huh JW, Kim YJ, Kim HR. Laparoscopic low anterior resection for hematogenous rectal metastasis from gastric adenocarcinoma: A case report. World Journal of Surgical Oncology. 2011;9:148CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Fisher ER, Brown CH. Linitis plastica carcinoma of the stomach with extensive metastases simulating a colonic lesion. Gastroenterology. 1952;20:503–508.PubMed Fisher ER, Brown CH. Linitis plastica carcinoma of the stomach with extensive metastases simulating a colonic lesion. Gastroenterology. 1952;20:503–508.PubMed
4.
Zurück zum Zitat Duarte I, Llanos O. Pattern of metastases in intestinal and diffuse types of carcinoma of the stomach. Hum Pathology. 1981;12:237–242.CrossRef Duarte I, Llanos O. Pattern of metastases in intestinal and diffuse types of carcinoma of the stomach. Hum Pathology. 1981;12:237–242.CrossRef
5.
Zurück zum Zitat Yamamto M, Matsuyama A, Kameyama T. Okamoto m. A case of advanced gastric cancer with Schnitzler’s metastases effectively treated by the combination of paclitaxel and S‑1. Gan To Kagaku Ryoho. 2008;35:829–831. Yamamto M, Matsuyama A, Kameyama T. Okamoto m. A case of advanced gastric cancer with Schnitzler’s metastases effectively treated by the combination of paclitaxel and S‑1. Gan To Kagaku Ryoho. 2008;35:829–831.
6.
Zurück zum Zitat Olano C, De Simone F, Gonzalez F, Gonzalez N, Tchekmedyian A, Pose A, et al. Stomach cancer presenting with rectal stenosis: Schnitzler’s metastasis. Gastrointestinal Endoscopy. 2009;70:809–810.CrossRefPubMed Olano C, De Simone F, Gonzalez F, Gonzalez N, Tchekmedyian A, Pose A, et al. Stomach cancer presenting with rectal stenosis: Schnitzler’s metastasis. Gastrointestinal Endoscopy. 2009;70:809–810.CrossRefPubMed
7.
Zurück zum Zitat Okugawa T, Oshima T, Ikeo K, Kondo T, Tomita T, Fukui H, et al. Successful self-expandable metallic Stent placement for a case of distal rectal Stenosis due to gastric cancer metastasis. Gastroenterology. 2013;7:214–218, Case Reports. Okugawa T, Oshima T, Ikeo K, Kondo T, Tomita T, Fukui H, et al. Successful self-expandable metallic Stent placement for a case of distal rectal Stenosis due to gastric cancer metastasis. Gastroenterology. 2013;7:214–218, Case Reports.
Metadaten
Titel
Gastric carcinoma presenting with severe rectal stenosis: ‘Schnitzler’s metastasis’: case report and review of the literature
verfasst von
Z. S. Derici, MD
S. Sokmen, MD. FACS FASCRS(Int’l) FASPSM Prof. of Surgery
Publikationsdatum
01.08.2016
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 4/2016
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-016-0390-8

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