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Rectal resection for Schnitzler’s metastasis in a patient presenting with severe rectal stenosis: case report and review of the literature

Year 2019, , 196 - 201, 04.01.2019
https://doi.org/10.18621/eurj.378526

Abstract

Rectal metastasis resulting from the hematogenous spread of
gastric cancer (Schnitzler’s disease) is rarely seen. We report a case of 53-year-old female with rectal metastasis from gastic cancer who presented with
abdominal pain, tenesmus, and severe constipation. Digital rectal examination
revealed a severe stenosis 5-6 cm from the dentate line. Sigmoidoscopy showed a
narrowed lumen at 5 cm up from the dentate line. The evident radiologic finding
was circumferential stenosis of the rectum located at the same level. Very low
anterior resection and total mesorectal excision with coloanal anastomosis in
addition to protective ileostomy were performed. Pathological examination
revealed metastatic adenocarcinoma (Schnitzler’s metastasis). The patient was
discharged on the 9th postoperative day with no adverse events. It
should be kept in mind that rectal stenosis could be metastasis from gastric
carcinoma if consistent with the patient’s history. 




References

  • [1] Maehara Y, Hasuda S, Koga T, Tokunaga E, Kakeji Y, Sugimachi K. Postoperative outcome and sites of recurrence in patients following curative resection of gastric cancer. Br J Surg 2000;87:353-7.
  • [2] Roviello F, Marrelli D, de Manzoni G, Morgagni P, Di Leo A, Saragoni L, et al. Prospective study of peritoneal recurrence after curative surgery for gastric cancer. Br J Surg 2003;90:1113-9.
  • [3] Niinobu T, Nakagawa S, Itani Y, Nishikawa Y, Amano M, Higaki N, et al. [Rectal stenosis due to Schnitzler metastasis following surgery for gastric cancer -a case successfully treated with TS-1 and CDDP combination chemotherapy]. Gan To Kagaku Ryoho 2005;32:1761-4. [Article in Japanese]
  • [4] Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality and prevalence across five continets: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006;24:2137-50.
  • [5] Yamamato M, Matsuyama A, Kameyama T, Okamato M, Okazaki J,Utsunomiya T,.et al. [A case of advanced gastric cancer with Schnitzler’s metastases effectively treated by combination of paclitaxel and S-1]. Gan To Kagaku. Ryhoho 2008;35 829-31. [Article in Japanese]
  • [6] Olano C, De Simone F, Gonzalez F, Gonzalez N, Tchekmedyian A, Pose A, et al. Stomach cancer presenting with rectal stenosis: Schnitzler’s metastasis. Gastrointest Endosc 2009;70:809-10.
  • [7] Rausei S, Frattini F, Dionigi G, Boni L, Rovera F, Diurni M. Unusual rectal stenosis. J Surg Oncol 2010;102:713.
  • [8] Lim SW, Huh JW, Kim YJ, Kim HR. Laparoscopic low anterior resection for hematogenous rectal metastasis from gastric adenocarcinoma: a case report. World J Surg Oncol 2011;9:148.
  • [9] Tural D, Selçukbiricik F, Erçalişkan A, Inanç B, Günver F, Büyükünal E. Metachronous rectum metastases from gastric adenocarcinoma: a case report. Case Rep Med 2012;2012:726841.
  • [10] Okugawa T, Oshima T, Ikeo K, Kondo T, Tomita T, Fukui H, et al. Successful self-expandable metallic stent placement for a case of distal rectal stenosis due to gastric cancer metastasis. Case Rep Gastroenterol 2013;7:214-8.
  • [11] Derici Z.S, Sokmen S. Gastric carcinoma presenting with severe rectal stenosis: ‘Schnitzler’s metastasis’: case report and rewiew of the literature. Eur Surg 2016:48:246-9.
  • [12] Uemura N, Kurashige J, Kosumi K, Iwatsuki M, Yamashita K, Iwagami S, et al. Early gastric cancer metastazing to thr rectum, possibly via hematogenous route:a case report and review of the literature. Surg Case Rep 2016:2:58.
  • [13] Matsutani T, Sasajima K, Amano H, Egami K, Kan H, Myashita M, et al. A case of expandable metallic stent placement for the stenosis in the sigmoid colon and rectum due to Schnitzler’s metastasis from gastric cancer. Gastroenterol Endosc 2005;47:343-7.
Year 2019, , 196 - 201, 04.01.2019
https://doi.org/10.18621/eurj.378526

Abstract

References

  • [1] Maehara Y, Hasuda S, Koga T, Tokunaga E, Kakeji Y, Sugimachi K. Postoperative outcome and sites of recurrence in patients following curative resection of gastric cancer. Br J Surg 2000;87:353-7.
  • [2] Roviello F, Marrelli D, de Manzoni G, Morgagni P, Di Leo A, Saragoni L, et al. Prospective study of peritoneal recurrence after curative surgery for gastric cancer. Br J Surg 2003;90:1113-9.
  • [3] Niinobu T, Nakagawa S, Itani Y, Nishikawa Y, Amano M, Higaki N, et al. [Rectal stenosis due to Schnitzler metastasis following surgery for gastric cancer -a case successfully treated with TS-1 and CDDP combination chemotherapy]. Gan To Kagaku Ryoho 2005;32:1761-4. [Article in Japanese]
  • [4] Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality and prevalence across five continets: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006;24:2137-50.
  • [5] Yamamato M, Matsuyama A, Kameyama T, Okamato M, Okazaki J,Utsunomiya T,.et al. [A case of advanced gastric cancer with Schnitzler’s metastases effectively treated by combination of paclitaxel and S-1]. Gan To Kagaku. Ryhoho 2008;35 829-31. [Article in Japanese]
  • [6] Olano C, De Simone F, Gonzalez F, Gonzalez N, Tchekmedyian A, Pose A, et al. Stomach cancer presenting with rectal stenosis: Schnitzler’s metastasis. Gastrointest Endosc 2009;70:809-10.
  • [7] Rausei S, Frattini F, Dionigi G, Boni L, Rovera F, Diurni M. Unusual rectal stenosis. J Surg Oncol 2010;102:713.
  • [8] Lim SW, Huh JW, Kim YJ, Kim HR. Laparoscopic low anterior resection for hematogenous rectal metastasis from gastric adenocarcinoma: a case report. World J Surg Oncol 2011;9:148.
  • [9] Tural D, Selçukbiricik F, Erçalişkan A, Inanç B, Günver F, Büyükünal E. Metachronous rectum metastases from gastric adenocarcinoma: a case report. Case Rep Med 2012;2012:726841.
  • [10] Okugawa T, Oshima T, Ikeo K, Kondo T, Tomita T, Fukui H, et al. Successful self-expandable metallic stent placement for a case of distal rectal stenosis due to gastric cancer metastasis. Case Rep Gastroenterol 2013;7:214-8.
  • [11] Derici Z.S, Sokmen S. Gastric carcinoma presenting with severe rectal stenosis: ‘Schnitzler’s metastasis’: case report and rewiew of the literature. Eur Surg 2016:48:246-9.
  • [12] Uemura N, Kurashige J, Kosumi K, Iwatsuki M, Yamashita K, Iwagami S, et al. Early gastric cancer metastazing to thr rectum, possibly via hematogenous route:a case report and review of the literature. Surg Case Rep 2016:2:58.
  • [13] Matsutani T, Sasajima K, Amano H, Egami K, Kan H, Myashita M, et al. A case of expandable metallic stent placement for the stenosis in the sigmoid colon and rectum due to Schnitzler’s metastasis from gastric cancer. Gastroenterol Endosc 2005;47:343-7.
There are 13 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Reports
Authors

Semra Doğan 0000-0003-1242-6239

Sezai Demirbaş This is me 0000-0002-5770-192X

Elgun Samadov This is me 0000-0003-0540-5667

Salih Erpulat Öziş This is me 0000-0002-1317-4881

Hatim Yahya Uslu This is me 0000-0002-8347-4740

Publication Date January 4, 2019
Submission Date January 13, 2018
Acceptance Date March 1, 2018
Published in Issue Year 2019

Cite

AMA Doğan S, Demirbaş S, Samadov E, Öziş SE, Uslu HY. Rectal resection for Schnitzler’s metastasis in a patient presenting with severe rectal stenosis: case report and review of the literature. Eur Res J. January 2019;5(1):196-201. doi:10.18621/eurj.378526

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