title: Gastric metastasis from salivary duct carcinoma mimicking primary gastric cancer.
abstract: BACKGROUND
  We present a very rare case of gastric metastasis mimicking primary gastric cancer in a patient who had undergone surgery for salivary duct carcinoma.
  
  
  METHODS
  A 67-year-old man had been diagnosed as having right parotid cancer and had undergone a right parotidectomy and lymph node dissection. The histological diagnosis was salivary duct carcinoma. One year after the surgery, a positron emission tomography-computed tomography scan using fluorodeoxyglucose (FDG) revealed an abnormal uptake of FDG in the left cervical, mediastinal, paraaortic, and cardiac lymph nodes; stomach; and pancreas. On gastroduodenoscopy, there was a huge, easily bleeding ulcer mimicking primary gastric cancer at the upper body of the stomach. Biopsy revealed poorly differentiated adenocarcinoma. Therefore, we were unable to differentiate between the primary gastric cancer and the metastatic tumor using gastroduodenoscopy and biopsy. Because of the uncontrollable bleeding from the gastric cancer, we performed an emergency palliative total gastrectomy. On histological examination, the gastric lesion was found to be metastatic carcinoma originating from the salivary duct carcinoma.
  
  
  CONCLUSIONS
  In the presented case, we could not diagnose the gastric metastasis originating from the salivary duct carcinoma even by endoscopic biopsy. This is because the histological appearance of salivary duct carcinoma is similar to that of high-grade adenocarcinoma, thus, resembling primary gastric cancer.
  
  
  CONCLUSIONS
  When we perform endoscopic examination of patients with malignant neoplasias, a possibility of metastatic gastric cancer should be taken into consideration.
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan. Electronic address: kanefumi0519@yahoo.co.jp.
authors.forename: Kanefumi
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Takeno
authors.affiliation: Department of Pathology, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nimura
authors.affiliation: Department of Otolaryngology, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Sugiyama
authors.affiliation: Department of Otolaryngology, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sueta
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Maki
authors.affiliation: Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kayashima
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Hironari
authors.initials: H
authors.lastname: Shiwaku
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kato
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hashimoto
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
keywords: Gastric metastasis; Salivary duct carcinoma; Salivary gland neoplasms