Korean J Gastrointest Endosc > Volume 31(1); 2005 > Article
Korean Journal of Gastrointestinal Endoscopy 2005;31(1): 68-72.
CA 19-9 상승으로 발견된 위암의 림프관성 췌장 전이
최창원·이홍식·이범재·김경진·김민정·정록선·임형준·진윤태·전훈재·엄순호·이상우·최재현·김창덕·류호상·현진해
고려대학교 의과대학 내과학교실, 소화기연구소
Lymphogenous Pancreatic Metastasis of Gastric Cancer Detected by Elevated CA 19-9 Level
Chang Won Choi, M.D., Hong Sik Lee, M.D., Beom Jae Lee, M.D., Keong Jin Kim, M.D., Min Jeong Kim, M.D., Rok Son Choung, M.D., Hyung Joon Yim, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Soon Ho Um, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang
Department of Internal Medicine, Institute of Digestive Diseases and Nutrition, Korea University College of Medicine, Seoul, Korea
Abstract
Pancreatic metastasis of gastric cancer almost takes the form of direct continous invasion to the pancreas from the primary lesions or dissemination. Isolated lymphogenous pancreatic metastasis of stomach cancer is rare. A 39- year-old woman was admitted to our institution due to high serum CA 19-9 level. Abdominal computed tomography showed a diffusely enlarged pancreas, and endoscopic retrograde cholangiopancreatography revealed a segmental stricture of pancreatic duct on mid-body. Ultrasonography guided pancreatic biopsy revealed a metastatic poorly differentiated adenocarcinoma with lymphatic tumor emboli. We perfomed esophagogastroduodenoscopy and total colonoscopy. There was a ulcerative lesion at the posterior wall of high body with clubbing change of surrounding mucosal folds. Endoscopic biopsy of the stomach lesion revealed a poorly differentiated adenocarcinoma. Positron emission tomography-computed tomography scan revealed bone metastasis in the sternum. Herein, we report a case of 39 year old female with the diagnosis of gastric adenocarcinoma, with lymphogenous pancreatic metastasis and solitary sternal metastasis detected by elevated serum CA 19-9 level. (Korean J Gastrointest Endosc 2005;31:68⁣72)
Key Words: Stomach cancer, Lymphogenous pancreatic metastasis, CA 19-9
주요어: 위암, 림프관성 췌장전이, CA19-9, 췌장암
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