Advanced Gastric Cancer With Cutaneous Metastases, With Effective Relief From Immunotherapy: Case Report
- 1Zhejiang Chinese Medical University Hangzhou 310053 Zhejiang China zcmu.edu.cn
- 2Department of Gastric Surgery Zhejiang Cancer Hospital Hangzhou Institute of Medicine (HIM) Chinese Academy of Sciences Hangzhou 310022 Zhejiang China cas.cn
- 3Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital) Hangzhou 310022 Zhejiang China zchospital.com
Abstract
Cutaneous metastases from gastric cancer are rare (<1%) and typically indicate advanced disease with poor prognosis. We report a unique case of a 53‐year‐old male presenting with an asymptomatic left temporal erythematous nodule, later diagnosed as metastatic gastric adenocarcinoma with signet‐ring cell features. Initial skin biopsy revealed adenocarcinoma (CDX2+/CK20+/CK7+), prompting gastrointestinal evaluation, which confirmed poorly differentiated gastric adenocarcinoma (30% signet‐ring cell component). The patient received neoadjuvant immunochemotherapy (paclitaxel+S‐1+sintilimab), followed by laparoscopic radical gastrectomy (D2 lymphadenectomy) and resection of the skin lesion. Postoperative pathology showed Becker grade 2 regression in the primary gastric tumor and Mandard grade 3 regression in the cutaneous metastasis. The surgical specimen showed metastasis in 20 of 65 lymph nodes and was staged ypT4aN3bM1 (AJCC 8th edition). Biomarker assessment demonstrated high Claudin18.2 expression (~90%) but low PD‐L1 expression (CPS ~1). Postoperative surveillance showed no radiographic local recurrence or distant metastasis through April 2025; however, leptomeningeal metastasis was confirmed by cerebrospinal fluid (CSF) cytology in May 2025. This case illustrates substantial early tumor regression with perioperative chemoimmunotherapy in an unusual metastatic presentation while also demonstrating that early response does not necessarily translate into durable disease control.
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BibTeX
@article{wang2026advanced,
title = {{Advanced Gastric Cancer With Cutaneous Metastases, With Effective Relief From Immunotherapy: Case Report}},
author = {Hongtao Wang and Pengfei Yu and Xiangliu Chen and Chengkang Zhu and Guangyu Ding and Shengxin Fang and Zequan Wu and Han Chen and Tengjiao Chai and Ling Huang},
journal = {Case Reports in Surgery},
year = {2026},
month = oct,
doi = {10.1155/cris/7879668},
url = {https://doi.org/10.1155/cris/7879668},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Advanced Gastric Cancer With Cutaneous Metastases, With Effective Relief From Immunotherapy: Case Report
AU - Hongtao Wang
AU - Pengfei Yu
AU - Xiangliu Chen
AU - Chengkang Zhu
AU - Guangyu Ding
AU - Shengxin Fang
AU - Zequan Wu
AU - Han Chen
AU - Tengjiao Chai
AU - Ling Huang
PY - 2026
DA - 2026/10/30
JO - Case Reports in Surgery
DO - 10.1155/cris/7879668
UR - https://doi.org/10.1155/cris/7879668
AB - Cutaneous metastases from gastric cancer are rare (<1%) and typically indicate advanced disease with poor prognosis. We report a unique case of a 53‐year‐old male presenting with an asymptomatic left temporal erythematous nodule, later diagnosed as metastatic gastric adenocarcinoma with signet‐ring cell features. Initial skin biopsy revealed adenocarcinoma (CDX2+/CK20+/CK7+), prompting gastrointestinal evaluation, which confirmed poorly differentiated gastric adenocarcinoma (30% signet‐ring cell component). The patient received neoadjuvant immunochemotherapy (paclitaxel+S‐1+sintilimab), followed by laparoscopic radical gastrectomy (D2 lymphadenectomy) and resection of the skin lesion. Postoperative pathology showed Becker grade 2 regression in the primary gastric tumor and Mandard grade 3 regression in the cutaneous metastasis. The surgical specimen showed metastasis in 20 of 65 lymph nodes and was staged ypT4aN3bM1 (AJCC 8th edition). Biomarker assessment demonstrated high Claudin18.2 expression (~90%) but low PD‐L1 expression (CPS ~1). Postoperative surveillance showed no radiographic local recurrence or distant metastasis through April 2025; however, leptomeningeal metastasis was confirmed by cerebrospinal fluid (CSF) cytology in May 2025. This case illustrates substantial early tumor regression with perioperative chemoimmunotherapy in an unusual metastatic presentation while also demonstrating that early response does not necessarily translate into durable disease control.
SN - 2090-6900
SN - 2090-6919
ER -