J Med Cases

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

Journal website http://www.journalmc.org

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

Figures

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. Adenocarcinoma cells in the cellblock specimen (H&E). These tumor cells show immunoreactivity for BerEP4, WT-1, p53, and PAX-8.

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. 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

**Table 1.** Summary of Reported Cases of PPSC Metastasizing to the Stomach
No.	Age (years)	Primary site	Time of diagnosis	Ovarian size	Survival at Reported FU	Reference
^†Primary debulking surgery. ^‡Not reported. ^§No evidence of disease. ^¶Dead of disease.
1	55	Ovary	7 years after PDS^†	NR^‡	NED^§	[1]
2	42	Ovary	18 years after PDS	NR	12 months NED	[2]
3	62	Ovary	10 months after PDS	NR	6 months DOD^¶	[3]
4	48	Ovary	21 years after PDS	NR	NR	[4]
5	65	Ovary	16 years after PDS	NR	DOD	[5]
6	51	Ovary	NR	114 × 94 mm	NR	[6]
7	49	Ovary	4.3 years after PDS	NR	18 months NED	[7]
8	70	Ovary	First diagnosis	NR	NR	[8]
9	61	Ovary	7 months after PDS	NR	18 months DOD	[9]
10	55	Ovary	First diagnosis	3 cm	12 months NED	[10]
11	61	Ovary	12 years after PDS	NR	5 months NED	[11]
12	58	Ovary	3 years after PDS	NR	NR	[12]
13	73	Ovary	7 years after PDS	NR	10 months DOD	[13]
14	64	Peritoneal carcinoma	First diagnosis	Normal size	18 months NED	[14]
15	62	Peritoneal carcinoma	First diagnosis	Normal size	6 months NED	Present case