Clinical case of complications of inguinal node metastatic lesion in gastric cancer after surgical treatment

Ivan Shtefanov, A.A. Zhakipova, Kymbat Mukhtarova, Manana Peradze, Абай Каиргожинович Макишев

2019

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DOI 10.29333/ejgm/115850
Data confidence 70 medium
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Abstract

Objective:To study the phenomena of complications of atypical distant lymphangitic metastasis by the example of gastric cancer.Methods:Within the framework of the study “Hereditary diffuse gastric cancer and measures for its prevention”, a clinical group and a control group of patients with the most likely risk of developing this genetic disease were recruited. DNA samples were taken from 119 patients of the main clinical group and the control group. In the course of filling out statistical charts, questioning and examination of patients, cases of distant lymphangitic and hematogenous metastasis were revealed in 7 patients. As diagnostic methods for distant lymphangitic and hematogenous metastasis, we used the results of studies of computed tomography, positron emission tomography combined with computed tomography of the whole body, nuclear magnetic resonance imaging, ultrasound methods, open biopsy and trephine-biopsy of lymph nodes.Results:Krukenberg’s tumors were detected in 2 patients, Virchow’s metastases - in 2 patients, metastases in the paraumbilical region - in 2 patients, Schnitzler metastases - in 1 patient, Irish node was detected in 1 of the examined patients. There was also a metastatic lesion of the lymph nodes of inguinal region on the left in 2 patients and one case of metastasis to the right testicle in a patient with true inguinal cryptorchidism. This article reflects one case of metastatic lesion of the inguinal nodes on the left and subsequent complications in the form of lymphostasis and pain syndrome.Conclusion:According to the classification of distant metastases in case of malignant neoplasms of the stomach, classical cases of metastases of Krukenberg, Virchow, Schnitzler, Sister Mary Joseph, and Irish were revealed. There is atypical metastasis to the inguinal nodes and to the undescended (true inguinal cryptorchidism) right testicle, which does not fall under the generally accepted classification of distant metastases of gastric cancer. Further tactics of treatment in the case of metastatic lesion to the inguinal regions in gastric cancer are not entirely clear, which requires an increase in the study of the amount of these clinical cases.