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Rare Endoscopic Manifestation of Pancreatic Adenocarcinoma

机译：胰腺癌的罕见内镜表现

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Gastric ulcer secondary to direct invasion from pancreatic adenocarcinoma is rare. Metastases to the stomach have been commonly reported with melanoma and with primary tumors of the breast, lung, ovary, liver, colon and testis. We report a patient who presented with epigastric pain and in whom subsequently upper endoscopy showed a malignant gastric ulcer secondary to direct invasion from pancreatic adenocarcinoma of the body. An 81-year-old female presented to our hospital with epigastric pain and subsequently underwent endoscopy with endoscopic ultrasound for evaluation of a pancreatic body mass. She had a large gastric ulcer in the fundus which was in direct continuity with the pancreatic mass. Pathology from biopsy of the ulcer revealed invasive well-to-moderately-differentiated adenocarcinoma, and immunohistochemical stains were strongly positive for CA19-9, CK7, CK19 and carcinoembryonic antigen. These findings were consistent with a histopathological diagnosis of metastatic carcinoma of the pancreas. Patients with gastrointestinal metastases usually have advanced malignancy with poor prognosis. Endoscopic evaluation with adequate biopsies should be performed for symptomatic patients.
机译：继发于胰腺腺癌直接侵袭的胃溃疡很少见。黑色素瘤以及乳腺癌，肺癌，卵巢癌，肝癌，结肠癌和睾丸癌等原发性肿瘤通常已报告到胃转移。我们报告了一名患者，出现上腹痛，随后其上内镜检查显示出继发于胰腺胰腺癌直接侵袭的恶性胃溃疡。一名81岁的女性因腹痛而到我们医院就诊，随后接受内镜超声检查以评估胰腺体重。她的胃底有大的胃溃疡，与胰腺肿块直接相连。溃疡的活检病理显示浸润性至中度分化的腺癌，并且免疫组织化学染色对CA19-9，CK7，CK19和癌胚抗原呈强阳性。这些发现与胰腺转移癌的组织病理学诊断一致。胃肠道转移患者通常患有晚期恶性肿瘤，预后较差。有症状的患者应进行内镜检查并进行充分的活检。

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