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Case ReportOpen Access

Synchronous Gastric Adenocarcinoma and Perigastric Lymph Node Metastatic Squamous Cell Carcinoma with Unknown Primary

Volume 6 - Issue 2

Bernard K Seshie1, Hyun Jung Lee2, Ki Hyun Kim3, Si Hak Lee4, Seong Geun Kim4 and Sun Hwi Hwang*3

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    • 1 Department of Surgery, Tema General Hospital, Ghana
    • 2Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, South Korea
    • 3Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, South Korea
    • 4Department of Internal Medicine, Pusan National University Yangsan Hospital, South Korea

    *Corresponding author: Sun Hwi Hwang, Department of Surgery and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea

Received: June 19, 2018;   Published: July 02, 2018

DOI: 10.26717/BJSTR.2018.06.001319

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Abstract

Background :Adenocarcinoma is the commonest histological form of Gastric cancer. But several unusual presentations have been reported. Perigastric lymph nodes are involved very early and are of prognostic importance. However, carcinoma from other organs can also spread to this lymph node group.

Case Presentation :We report a case of 65 years old man who was found on routine Esophagogastroduodenoscopy to have gastric tumour. Histology revealed adenocarcinoma. Staging investigation with abdominal computed tomography (CT) and Positron emission tomography, fluorine-18 fluoro- 2-2deoxy-D-glucose (PET-CT: F-18 FDG) Torso (Skull base to thigh) confirmed gastric cancer of the antrum with lymph node enlargement at hepatoduodenal ligament. The patient underwent laparoscopic assisted distal gastrectomy with D2 lymphadenectomy. Pathology revealed intestinal type moderately differentiated tubular adenocarcinoma invading lamina propria (pT1a). Four positive lymph nodes out of 34 did not show metastatic adenocarcinoma but rather Squamous Cell Carcinoma (SCC) and were positive for p63 and CK5/6 on immune histo chemistary. Primary site of SCC was not found. He received adjuvant chemotherapy with TS-1 60mg. After two years of follow-up he is asymptomatic and repeated EGD and abdominal CT Scan were normal.

Keywords: Adenocarcinoma; Metastasis; Perigastric Lymph Node; Synchronous; Squamous cell Carcinoma

Abbreviations: GC: Gastric Cancer; LN: Lymph Nodes; CUP: Cancer Of Unknown Primary; SCC: Squamous Cell Carcinoma; EGD: Esophagogastroduodenoscopy; CT Scan: Computed Tomography Scan; PET-CTF-18 FDG: Positron Emission Tomography; Fluorine-18 Fluoro- 2-2deoxy-D-glucose; CK: Cytokeratin

Abstract| Introduction| Case Presentation| Discussion and Conclusion| Conclusion| References|