Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 7, Number 11, November 2016, pages 480-483

A Primary Peritoneal Serous Carcinoma Metastasizing to the Stomach Mimicking a Submucosal Tumor: A Potential Pitfall of Clinical Diagnosis


Figure 1.
Figure 1. (A) A contrast-enhanced CT scan, showing large amounts of ascites and omental caking. (B) Upper gastrointestinal fiberscope showed a 4-cm submucosal mass without ulceration on the posterior wall of the lesser curvature of the gastric antrum (arrowhead).
Figure 2.
Figure 2. Adenocarcinoma cells in the cellblock specimen (H&E). These tumor cells show immunoreactivity for BerEP4, WT-1, p53, and PAX-8.
Figure 3.
Figure 3. Uterus and bilateral adnexae. (A) Anterior view and (B) Posterior view. Both the ovaries (arrow) and the fallopian tubes are macroscopically intact.
Figure 4.
Figure 4. High-grade serous adenocarcinoma (H&E). (A) High-grade serous adenocarcinoma in the omentum. (B) High-power view, adenocarcinoma cells show nuclear atypia. Psammoma bodies are also observed (arrow). (C) Gastric metastasis from a peritoneal serous adenocarcinoma, covered with intact gastric mucosa (arrow). (D) Adenocarcinoma cells showing similar morphology to those of the omentum.


Table 1. Summary of Reported Cases of PPSC Metastasizing to the Stomach
No.Age (years)Primary siteTime of diagnosisOvarian sizeSurvival at Reported FUReference
Primary debulking surgery. Not reported. §No evidence of disease. Dead of disease.
155Ovary7 years after PDSNRNED§[1]
242Ovary18 years after PDSNR12 months NED[2]
362Ovary10 months after PDSNR6 months DOD[3]
448Ovary21 years after PDSNRNR[4]
565Ovary16 years after PDSNRDOD[5]
651OvaryNR114 × 94 mmNR[6]
749Ovary4.3 years after PDSNR18 months NED[7]
870OvaryFirst diagnosisNRNR[8]
961Ovary7 months after PDSNR18 months DOD[9]
1055OvaryFirst diagnosis3 cm12 months NED[10]
1161Ovary12 years after PDSNR5 months NED[11]
1258Ovary3 years after PDSNRNR[12]
1373Ovary7 years after PDSNR10 months DOD[13]
1464Peritoneal carcinomaFirst diagnosisNormal size18 months NED[14]
1562Peritoneal carcinomaFirst diagnosisNormal size6 months NEDPresent case