A sequentially metastatic gastric and jejunal cancer originating from colon cancer: A case report

INTRODUCTION: Metastatic intraluminal cancer arising from gastrointestinal tract cancer is very rare. In this report, we describe a case of an 82-year-old man with sequentially metastatic gastric and jejunal cancer originating from primary colon cancer. PRESENTATION OF CASE: An 82-year-old Korean male patient with a history of right colon cancer was initially treated with extended right hemicolectomy. The tumour was classified as pT3N0M0 and stage II. After nine months, a gastroscopy revealed an infiltrating ulcerative mass in the cardia of the stomach, a colonoscopy revealed no specific findings in the previous operation site, and a positron emission tomography-computed tomography scan revealed no distant metastasis. The patient underwent radical total gastrectomy, and the final pathologic diagnosis was T3N2M0, stage IIIA. During follow-up without chemotherapy, a gastroscopy revealed tumours in the blind jejunal loop of Roux-en-Y anastomosis, and an endoscopic biopsy confirmed adenocarcinoma. The patient then underwent segmental resection of the blind loop jejunal cancer. Finally, further pathological examination of the resected specimen confirmed that the lesion represented a sequentially metastatic gastric and jejunal cancer originating from colon cancer. DISCUSSION: The exact mechanism of intraluminal metastasis of gastrointestinal tract cancer is not known. Immunohistochemical staining might prove useful in sequentially metastatic cases when a differential diagnosis must be assessed on consecutive biopsies. CONCLUSION: Although intraluminal metastasis of gastrointestinal tract cancer is very rare, researchers should be aware of this uncommon intraluminal metastasis.