Gastric Cancer: A Multidisciplinary Approach

No.  Intramural gastric metastases can mimic primary gastric lesions both clinically and histologically. Breast cancer is one of the more common malignancies that can infiltrate the gastric wall, appearing as “linitis plastica.” Other malignancies that may produce a similar pattern are metastatic lung cancer and melanoma. Ascertaining a correct diagnosis, therefore, requires a systematic approach and includes considering the possibility of metastasis in every patient with a history of malignancy, correlating the current pathology with the original neoplasm in those cases and evaluating a differentiating panel of immunohistochemical stains. Hence, in case of our patient with a history of breast cancer, the diagnosis was made after differential staining for GATA3, ER, synaptophysin and CDX-2.  Her tumor was negative for GATA3 (L50-823, Ventana), ER (ER1D5, Dako) but positive with CDX-2 (EP25, Leica), consistent with the diagnosis of diffuse-type gastric carcinoma.

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