Hungarian Radiology

[Metastasis of the large bowel from gastric signet-ring cell carcinoma - Case report]

TÓTH Géza, LUKOVICS Péter, LÁHM Erika, KOVÁCS Margit

DECEMBER 20, 2004

Hungarian Radiology - 2004;78(06)

[INTRODUCTION - Metastatic tumor of the colon is extremely rare. It could mimic inflammatory bowel disease or ischemic colitis. CASE REPORT - A 59-year-old female underwent gastrectomy because of primary signet-ring cell carcinoma of the stomach in 1999. In November 2003 follow-up CT detected circular and segmental thickening of the wall of the transverse colon with significant targetlike contrast enchancement of the inner layers. Colonoscopy was performed but due to the significant stenosis of the transverse colon, the tumor was not properly examined. Biopsy was taken from the beginning of the stenosis, which did not prove neither specific inflammation or malignancy. Barium enema and virtual colonoscopy was performed. There was mild dilatation of the stenotic part and mucosa seemed to be intact by virtual colonoscopy. Barium enema showed significant stenosis and polypoid alteration of the mucosa in the right part of the colon. There was also an asymmetric bowel wall thickening of the flexura lienalis. Because of subileus the patient was operated on, and an extended right hemicolectomy was made. The histology of the specimen verified secondary signet-ring cell tumor of the colon. CONCLUSION - In case of multiple circular and segmental thickening of the wall of the colon, with striking thickening of the enchancing inner layer with decreased contrast enhancement in the outer layer (target pattern) on the CT, the metastasis of the large bowel should be considered.]

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