Title:
Rare Cutaneous Metastases From Gastric Cancer Authors:
Lu-Yen Chu, MD, Te-Chun Hsia, MD, Te-Chun Hsieh, MD, Kuo-Yang Yen, BSc
and Chia-Hung Kao, MD
Affiliations of Authors:
Department of Nuclear Medicine and Positron Emission Tomography Center, China Medical University Hospital, Taichung, Taiwan
Corresponding Author:
Chia-Hung Kao, MD, Department of Nuclear Medicine and Positron Emission Tomography Center, China Medical University Hospital, Taichung, Taiwan. [email protected]
Illustrations:
It is very rare that gastric cancer presents with cutaneous metastases. Therefore, we present a 57-year-old male patient with gastric cancer and cutaneous metastases which were detected by 18F- fluoride (F-18) 2-deoxy-2- fluoro-D-glucose (FDG) positron emission tomography (PET).
This patient initially presented with shortness of breath and skin nodules over his whole body. His F-18 FDG PET images demonstrated abnormal FDG uptake in lymph nodes, pleura, mediastinum and lung on coronal images (Figure 1A). Hypermetabolic radioactivity was observed in cutaneous tissue over whole body on sagittal (Figure 1B) and maximum intensity projection PET images (Figure 1C). Skin biopsy of his left arm revealed metastatic adenocarcinoma. Finally, histology of gastroscopic specimen correlated intestinal type of gastric adenocarcinoma with metastatic cutaneous deposits. Cutaneous metastases are relatively rare in advanced gastric cancer.1,2 F-18
FDG PET may have a role in preoperative staging of gastric cancer, and therefore, it is greatly useful to detect distant metastases with an overall accuracy of 88% in F-18 FDG PET.3
References:
1. Bhure U, Schmitt AM, Pestalozzi BC, et al. FDG-negative signet ring cell cancer of the stomach with FDG-positive skin metastases. Clin Nucl Med 2007;32:226-8.
2. Hoffmann M, Oberhuber G, Kletter K, et al. Imaging of cutaneous
recurrence of gastric cancer with F-18 FDG positron emission tomography. Clin Nucl Med 2002;27:731-2.
3. Shimada H, Okaz umi S, Koyama M , et al. Japanese Gastric Cancer Association Task Force for Rese arch Promotion: clinical utility of 18F-fluoro-2-deoxyglucose positron emission tomography in gastric cancer. A systematic review of the literature. Gastric Cancer 2011;14:13-21.
