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KMID : 0359020050310010068
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Korean Journal of Gastrointestinal Endoscopy
2005 Volume.31 No. 1 p.68 ~ p.72
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Lymphogenous Pancreatic Metastasis of Gastric Cancer Detected by Elevated CA 19-9 Level
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Choi Chang-Won
Lee Beom-Jae
Chun Hoon-Jai
Lee Hong-Sik
Um Soon-Ho
Lee Sang-Woo
Choi Jai-Hyun
Kim Chang-Duck
Ryu Ho-Sang
Yim Hyung-Joon
Hyun Jin-Hai
Jin Yoon-Tae
Kim Kyeong-Jin
Kim Min-Jeong
Choung Rok-Seon
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Abstract
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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)
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KEYWORD
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Stomach cancer, Lymphogenous pancreatic metastasis, CA 19-9
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