Tuberc Respir Dis.  2009 Jan;66(1):52-57.

Gastric Metastasis of Primary Lung Adenocarcinoma Mistaken for Primary Gastric Cancer

• Park YS
• Lee JW
• Lim HJ
• Lee GK
• Hwangbo B
• Lee HS

Abstract

The stomach is a rare site for metastasis, with autopsy incidence rates of 0.2% to 1.7%. This low rate makes diagnosis of metastatic gastric cancer challenging for clinicians. The authors report a case of a 64-year-old man diagnosed with gastric metastasis of primary lung adenocarcinoma that was initially mistaken for primary gastric cancer, as well as a review of the medical literature.

Keyword

Lung cancer; Stomach cancer; Metastasis; Hemoptysis; Hematemesis

MeSH Terms

Adenocarcinoma
Autopsy
Hematemesis
Hemoptysis
Humans
Incidence
Lung
Lung Neoplasms
Middle Aged
Neoplasm Metastasis
Stomach
Stomach Neoplasms
Adenocarcinoma
Lung Neoplasms

Figure

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  Figure 1 Initial gastrofiberscopy showed 3.2 cm sized polypoid mass with ulceration in the body of stomach.

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  Figure 2 (A) Chest X-ray taken during the admission for gastrectomy showed a ground-glass opacity (GGO) lesion in the right upper lobe. (B) CT scan taken 2 months after subtotal gastrectomy showed a GGO lesion with solid portion in the right upper lobe. (C, D) Chest X-ray and CT scan taken 11 months after right upper lobectomy showed a mass with surrounding ground-glass opacity in the left lower lobe.

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  Figure 3 (A) Hematoxylin and eosin (H&E) stain in the lung tissue obtained by percutaneous needle biopsy (×100). A papillary pattern and undifferentiated diffuse proliferation, suggesting poorly differentiated adenocarcinoma are observed. (B) Immunohistochemical stain for thyroid transcription factor-1 (TTF-1) in the lung tissue obtained by percutaneous needle biopsy (×100). The strong positive staining with TTF-1 is observed. (C) H&E stain in the gastrectomy specimen (×100). The tumor cells of stomach are similar to the adenocarcinoma observed in the lung tissue. (D) Immunohistochemical stain for TTF-1 in the gastrectomy specimen (×100). The strong positive staining with TTF-1 is observed.

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