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Diffuse Gastric Cancer with Peritoneal Carcinomatosis Can Mimic Crohn's Disease

In some cases the diagnosis of gastric cancer is difficult and the endoscopic presentation may be misleading. Diffuse type gastric carcinoma with peritoneal metastasis may present primarily with abdominal pain, colonic infiltration and/or diarrhea, thus other differential diagnoses like Crohn's...

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Autores principales: Hommel, C., Knoedler, M., Bojarski, C., Schumann, M., Epple, H.J., Zeitz, M., Daum, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506060/
https://www.ncbi.nlm.nih.gov/pubmed/23185152
http://dx.doi.org/10.1159/000345385
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author Hommel, C.
Knoedler, M.
Bojarski, C.
Schumann, M.
Epple, H.J.
Zeitz, M.
Daum, S.
author_facet Hommel, C.
Knoedler, M.
Bojarski, C.
Schumann, M.
Epple, H.J.
Zeitz, M.
Daum, S.
author_sort Hommel, C.
collection PubMed
description In some cases the diagnosis of gastric cancer is difficult and the endoscopic presentation may be misleading. Diffuse type gastric carcinoma with peritoneal metastasis may present primarily with abdominal pain, colonic infiltration and/or diarrhea, thus other differential diagnoses like Crohn's disease (CD) may be considered at first. Therefore intensive diagnostic work-up is important. We report two cases of gastric cancer with ascites due to peritoneal carcinomatosis who were first diagnosed as CD. The patients were hospitalized in different institutions for weight loss, abdominal pain and nausea. The first colonoscopy, upper endoscopy with multiple biopsies and ascites puncture were negative for malignant disease, but macroscopic lesions resembling CD were described. Both patients were released on a prednisolone-based treatment for suspected CD. They presented to our hospital for further evaluation due to persistent symptoms. Neither lower nor upper endoscopy were suggestive of CD and endoscopic ultrasound was suspicious of malignancy in one case. Histology was diagnostic and showed gastric infiltration by a poorly differentiated adenocarcinoma. Diffuse type gastric cancer (gastric linitis plastica) with peritoneal metastasis may mimic certain clinical, endoscopic and CT imaging features of CD. Repeated biopsies and endoscopic investigations are often necessary to confirm a malignant process, especially in case of an inconclusive clinical and endoscopic picture. Endoscopic ultrasound may be useful to evaluate the risk of malignancy in patients with macroscopic suspicion of malignancy and negative biopsies.
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spelling pubmed-35060602012-11-26 Diffuse Gastric Cancer with Peritoneal Carcinomatosis Can Mimic Crohn's Disease Hommel, C. Knoedler, M. Bojarski, C. Schumann, M. Epple, H.J. Zeitz, M. Daum, S. Case Rep Gastroenterol Published online: November, 2012 In some cases the diagnosis of gastric cancer is difficult and the endoscopic presentation may be misleading. Diffuse type gastric carcinoma with peritoneal metastasis may present primarily with abdominal pain, colonic infiltration and/or diarrhea, thus other differential diagnoses like Crohn's disease (CD) may be considered at first. Therefore intensive diagnostic work-up is important. We report two cases of gastric cancer with ascites due to peritoneal carcinomatosis who were first diagnosed as CD. The patients were hospitalized in different institutions for weight loss, abdominal pain and nausea. The first colonoscopy, upper endoscopy with multiple biopsies and ascites puncture were negative for malignant disease, but macroscopic lesions resembling CD were described. Both patients were released on a prednisolone-based treatment for suspected CD. They presented to our hospital for further evaluation due to persistent symptoms. Neither lower nor upper endoscopy were suggestive of CD and endoscopic ultrasound was suspicious of malignancy in one case. Histology was diagnostic and showed gastric infiltration by a poorly differentiated adenocarcinoma. Diffuse type gastric cancer (gastric linitis plastica) with peritoneal metastasis may mimic certain clinical, endoscopic and CT imaging features of CD. Repeated biopsies and endoscopic investigations are often necessary to confirm a malignant process, especially in case of an inconclusive clinical and endoscopic picture. Endoscopic ultrasound may be useful to evaluate the risk of malignancy in patients with macroscopic suspicion of malignancy and negative biopsies. S. Karger AG 2012-11-07 /pmc/articles/PMC3506060/ /pubmed/23185152 http://dx.doi.org/10.1159/000345385 Text en Copyright © 2012 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Published online: November, 2012
Hommel, C.
Knoedler, M.
Bojarski, C.
Schumann, M.
Epple, H.J.
Zeitz, M.
Daum, S.
Diffuse Gastric Cancer with Peritoneal Carcinomatosis Can Mimic Crohn's Disease
title Diffuse Gastric Cancer with Peritoneal Carcinomatosis Can Mimic Crohn's Disease
title_full Diffuse Gastric Cancer with Peritoneal Carcinomatosis Can Mimic Crohn's Disease
title_fullStr Diffuse Gastric Cancer with Peritoneal Carcinomatosis Can Mimic Crohn's Disease
title_full_unstemmed Diffuse Gastric Cancer with Peritoneal Carcinomatosis Can Mimic Crohn's Disease
title_short Diffuse Gastric Cancer with Peritoneal Carcinomatosis Can Mimic Crohn's Disease
title_sort diffuse gastric cancer with peritoneal carcinomatosis can mimic crohn's disease
topic Published online: November, 2012
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506060/
https://www.ncbi.nlm.nih.gov/pubmed/23185152
http://dx.doi.org/10.1159/000345385
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