Preview

Siberian journal of oncology

Advanced search

Generalized lymphogenous metastasis involving parenchymal organs in gastric cancer (case report)

https://doi.org/10.21294/1814-4861-2025-24-1-189-198

Abstract

Generalized metastases to parenchymatous organs in gastric cancer are usually associated with hematogenous spread of cancer cells. Generalized lymphogenous metastasis involves the spread of cancer cells to distant lymph nodes and serous membranes. There is very little information on generalized metastases to parenchymatous organs due to tumor embolism of their lymphatic vessels. Objective: to present a fatal case with generalized lymphogenous metastases to parenchymatous organs. Case presentation. A 56-year-old female patient with gastric cancer presented to the hospital with generalized lymphogenous metastases to parenchymatous organs. The patient received palliative treatment in the hospital for 11 days. The pathological examination showed extensive lymphovascular invasion with massive embolism of the lymphatic vessels of the peritoneum, pleura, pericardium, retroperitoneal tissue and almost all organs except the brain. Tumor emboli in the lymphatic vessels intensively expressed integrin subunits a6 and b4, as well as the laminin subunit γ2. Conclusion. Widespread metastases to parenchymatous organs may be caused by tumor embolism of the lymphatic vessels. This variant of progression may be associated with the expression of integrin subunits α6 and β4, as well as the laminin subunit γ2 by tumor cells.

About the Authors

M. V. Zavyalova
Siberian State Medical University of the Ministry of Health of Russia; Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Marina V. Zavyalova - MD, DSc, Professor, Leading Researcher, Department of General and Molecular Pathology, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Head of Pathology Department, Siberian State Medical University of the Ministry of Health of Russia.

2, Moskovsky trakt, Tomsk, 634050; 5, Kooperativny St., Tomsk, 634009

Researcher ID (WOS) С-8580-2012, Author ID (Scopus) 36711031100



A. V. Zavyalov
Siberian State Medical University of the Ministry of Health of Russia
Russian Federation

Aleksandr V. Zavyalov - 3th year student, Medical Faculty, Siberian State Medical University of the Ministry of Health of Russia.

2, Moskovsky trakt, Tomsk, 634050



E. S. Pudova
Siberian State Medical University of the Ministry of Health of Russia; Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Elena S. Pudova - MD, Junior Researcher, Department of General and Molecular Pathology, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Assistant, Pathology Department, Siberian State Medical University of the Ministry of Health of Russia.

2, Moskovsky trakt, Tomsk, 634050; 5, Kooperativny St., Tomsk, 634009

Researcher ID (WOS) HLQ-4107-2023, Author ID (Scopus) 57345049300



I. G. Kutsenko
Siberian State Medical University of the Ministry of Health of Russia
Russian Federation

Irina G. Kutsenko - MD, PhD, DSc, Associate Professor, Head of the Department of Obstetrics and Gynecology, Siberian State Medical University of the Ministry of Health of Russia.

2, Moskovsky trakt, Tomsk, 634050



M. A. Egunova
Siberian State Medical University of the Ministry of Health of Russia
Russian Federation

Maria A. Egunova - MD, PhD, Assistant, Department of Obstetrics and Gynecology, Siberian State Medical University of the Ministry of Health of Russia.

2, Moskovsky trakt, Tomsk, 634050



K. A. Klyaus
Siberian State Medical University of the Ministry of Health of Russia
Russian Federation

Kristina A. Klyaus - 4th year student, Medical Faculty, Siberian State Medical University of the Ministry of Health of Russia.

2, Moskovsky trakt, Tomsk, 634050



D. A. Orel
Siberian State Medical University of the Ministry of Health of Russia
Russian Federation

Dmitry A. Orel - MD, Surgeon, Hospital clinics named after A.G. Savinykh, Siberian State Medical University of the Ministry of Health of Russia.

2, Moskovsky trakt, Tomsk, 634050



S. V. Vtorushin
Siberian State Medical University of the Ministry of Health of Russia; Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Sergey V. Vtorushin - MD, DSc, Professor, Head of Department of General and Molecular Pathology, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; Professor, Pathology Department, Siberian State Medical University of the Ministry of Health of Russia.

2, Moskovsky trakt, Tomsk, 634050; 5, Kooperativny St., Tomsk, 634009

Researcher ID (WOS) S-3789-2016, Author ID (Scopus) 26654562300



V. M. Perelmuter
Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation

Vladimir M. Perelmuter - MD, DSc, Professor, Chief Researcher, Department of General and Molecular Pathology, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences.

5, Kooperativny St., Tomsk, 634009



References

1. Cancer care for the population of Russia in 2022. Ed. by A.D. Kaprin, V.V. Starinsky, A.O. Shakhzadova. Moscow, 2023. 252 p. (in Russian).

2. Grigoryeva E.S., Cherdyntseva N.V., Karbyshev M.S., Volkomorov V.V., Stepanov I.V., Zavyalova M.V., Perelmuter V.M., Buldakov M.A., Afanasyev S.G., Tuzikov S.A., Bukurova Y.A., Lisitsyn N.A., Beresten S.F. Expression of Cyclophilin A in Gastric Adenocarcinoma Patients and Its Inverse Association with Local Relapses and Distant Metastasis. Pathol. Oncol. Res. 2014 Apr; 20(2): 467–73. doi: 10.1007/s12253-013-9718-x.

3. Li W., Wang H., Wang J., Fangfang L.V., Zhu X., Wang Z. Ovarian metastases resection from extragenital primary sites: outcome and prognostic factor analysis of 147 patients. BMC Cancer. 2012; 12: 278. doi: 10.1186/1471-2407-12-278.

4. Peng W., Hua R.X., Jiang R., Ren C., Jia Y.N., Li J., Guo W.J. Surgical treatment for patients with Krukenberg tumor of stomach origin: clinical outcome and prognostic factors analysis. PLoS One. 2013; 8(7). doi: 10.1371/journal.pone.0068227.

5. Kakushima N., Kamoshida T., Hirai S., Hotta S., Hirayama T., Yamada J., Ueda K., Sato M., Okumura M., Shimokama T., Oka Y. Early gastric cancer with Krukenberg tumor and review of cases of intramucosal gastric cancers with Krukenberg tumor. J Gastroenterol. 2003; 38(12): 1176–80. doi: 10.1007/s00535-003-1227-3.

6. Karaman S., Detmar M. Mechanisms of lymphatic metastasis. J Clin Invest. 2014; 124(3): 922–8. doi: 10.1172/JCI71606.

7. Yamanishi Y., Koshiyama M., Ohnaka M., Ueda M., Ukita S., Hishikawa K., Nagura M., Kim T., Hirose M., Ozasa H., Shirase T. Pathways of metastases from primary organs to the ovaries. Obstet Gynecol Int. 2011. doi: 10.1155/2011/612817.

8. TanakaT.,IshiguroH.,KuwabaraY.,KimuraM.,MitsuiA.,KatadaT., Shiozaki M., Naganawa Y., Fujii Y., Takeyama H. Vascular endothelial growth factor C (VEGF-C) in esophageal cancer correlates with lymph node metastasis and poor patient prognosis. J Exp Clin Cancer Res. 2010; 29(1): 83. doi: 10.1186/1756-9966-29-83.

9. Skoropad V.Yu., Berdov B.A., Davtyan A.G. Comparative analysis of clinical manifestations and features of metastasis of differentiated adeno- carcinoma and undifferentiated gastric cancer. Siberian journal of oncology. 2012; (4): 20–24. (in Russian). EDN: PBSDNJ.

10. Degiuli M., Borasi A., Forchino F., Marano A., Vendrame A., Casella D., Ponti A., Mussa B., Sandrucci S. Lymph-nodal ratio in gastric cancer staging system. Minerva Chirurgica. 2011; 66(3): 177–82.

11. Nered S.N., Klimenkov A.A., Perevostchikov A.G. Clinicomorphological features of signet-ring cell carcinoma of the stomach. Vestn. RONC named after. N. N. Blokhin RAMS. 2004; 3: 37–42. (in Russian). EDN: HPMSFH.

12. Zahir N., Lakins J.N., Russell A., Ming W., Chatterjee C., Rozenberg G.I., Marinkovich M.P., Weaver V.M. Autocrine laminin-5 ligates alpha6beta4 integrin and activates RAC and NFkappaB to mediate anchorage-independent survival of mammary tumors. J Cell Biol. 2003; 163(6): 1397–407. doi: 10.1083/jcb.200302023.


Review

For citations:


Zavyalova M.V., Zavyalov A.V., Pudova E.S., Kutsenko I.G., Egunova M.A., Klyaus K.A., Orel D.A., Vtorushin S.V., Perelmuter V.M. Generalized lymphogenous metastasis involving parenchymal organs in gastric cancer (case report). Siberian journal of oncology. 2025;24(1):189-198. (In Russ.) https://doi.org/10.21294/1814-4861-2025-24-1-189-198

Views: 998


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1814-4861 (Print)
ISSN 2312-3168 (Online)