Korean J Gastrointest Endosc.  2005 Jul;31(1):68-72.

Lymphogenous Pancreatic Metastasis of Gastric Cancer Detected by Elevated CA 19-9 Level

• Choi CW
• Lee HS
• Lee BJ
• Kim KJ
• Kim MJ
• Choung RS
• Yim HJ
• Jeen YT
• Chun HJ
• Um SH
• Lee SW
• Choi JH
• Kim CD
• Ryu HS
• Hyun JH

Abstract

Pancreatic metastasis of gastric cancer almost takes the form of direct continous invasion to the pancreas from the primary lesions or dissemination. Isolated lymphogenous pancreatic metastasis of stomach cancer is rare. A 39-year-old woman was admitted to our institution due to high serum CA 19-9 level. Abdominal computed tomography showed a diffusely enlarged pancreas, and endoscopic retrograde cholangiopancreatography revealed a segmental stricture of pancreatic duct on mid-body. Ultrasonography guided pancreatic biopsy revealed a metastatic poorly differentiated adenocarcinoma with lymphatic tumor emboli. We perfomed esophagogastroduodenoscopy and total colonoscopy. There was a ulcerative lesion at the posterior wall of high body with clubbing change of surrounding mucosal folds. Endoscopic biopsy of the stomach lesion revealed a poorly differentiated adenocarcinoma. Positron emission tomography-computed tomography scan revealed bone metastasis in the sternum. Herein, we report a case of 39 year old female with the diagnosis of gastric adenocarcinoma, with lymphogenous pancreatic metastasis and solitary sternal metastasis detected by elevated serum CA 19-9 level.

Keyword

Stomach cancer; Lymphogenous pancreatic metastasis; CA 19-9

MeSH Terms

Adenocarcinoma
Adult
Biopsy
Cholangiopancreatography, Endoscopic Retrograde
Colonoscopy
Constriction, Pathologic
Diagnosis
Electrons
Endoscopy, Digestive System
Female
Humans
Neoplasm Metastasis*
Pancreas
Pancreatic Ducts
Sternum
Stomach
Stomach Neoplasms*
Ulcer
Ultrasonography