title: Gastric metastasis of cervix uteri carcinoma, rare cause of lower gastric stenosis.
abstract: OBJECTIVE
  the paper presents a rare case of metachronous gastric metastasis of uterine cervix cancer, clinically manifested through severe pyloric stenosis.
  
  
  METHODS
  49-year-old patient, operated on in January 2009, with uterine cervix cancer (Squamous cell carcinoma T2bN1M0), is hospitalized in August 2011 with pyloric stenosis: epigastric pains, abundant, stasis, late postprandial emesis, significant weight loss, stomach form visible upon abdomen inspection. Endoscopy: antral stenosis with intact gastric mucosa, and CT-scan: circumferential intramural gastric tumor, stomach dilated in the upper part, lack of cleavage between the tumor and the liver bed of the gall bladder. CEA increased to 13,78 (below 5), CA 19-9 slightly increased 29.9 (below 27). The case is considered as a second neoplasia and a D2 subtotal gastrectomy was performed, with 1 positive ganglion out of 27 on block with atypical hepatectomy of segments 4-5 for liver invasion, the final mounting being Y Roux.
  
  
  RESULTS
  The histopathological examination shows a gastric metastasis of squamous carcinoma, of uterine cervix origin, the invaded perigastric ganglion having the same aspect of uterine cervix carcinoma. The post-surgery evolution was favorable, under chemo radiotherapy the patient being alive without relapse at 9 months post-surgery.
  
  
  CONCLUSIONS
  In the literature there are 2 more cases of gastric metastasis of uterine cervix carcinoma, and 4 of uterine carcinoma without topographic indication, but without the histological documentation of the tumor filiation, without data related to resecability or follow-up, the case at hand being, from this perspective, the first documented resectable metachronous gastric metastasis from a cervix uteri carcinoma.
authors.affiliation: General Surgery Department, Sf. Constantin Hospital Braşov, Romania. bogdan.moldovan@spitalulsfconstantin.ro
authors.forename: B
authors.initials: B
authors.lastname: Moldovan
authors.forename: E
authors.initials: E
authors.lastname: Banu
authors.forename: D
authors.initials: D
authors.lastname: Pocreaţă
authors.forename: R
authors.initials: R
authors.lastname: Buiga
authors.forename: S
authors.initials: S
authors.lastname: Rogoz
authors.forename: L
authors.initials: L
authors.lastname: Pripisi
authors.forename: L
authors.initials: L
authors.lastname: Cimpeanu
authors.forename: A
authors.initials: A
authors.lastname: Moldovan
authors.forename: O
authors.initials: O
authors.lastname: Jeder
authors.forename: A
authors.initials: A
authors.lastname: Badea
authors.forename: P
authors.initials: P
authors.lastname: Biris
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011707:Pyloric Stenosis / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D013274:Stomach Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy