Unusual manifestation of gastric adenocarcinoma presenting with lymphedema, chylothorax, and chylous ascites.
Chylothorax
Chylous ascites
Gastric cancer
Lymphedema
Parenteral nutrition
Journal
Clinical journal of gastroenterology
ISSN: 1865-7265
Titre abrégé: Clin J Gastroenterol
Pays: Japan
ID NLM: 101477246
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
02
01
2023
accepted:
18
08
2023
medline:
27
11
2023
pubmed:
22
9
2023
entrez:
22
9
2023
Statut:
ppublish
Résumé
A 62-year-old Thai man with a 2-year history of bilateral lymphedema and an unprovoked left axillary vein thrombosis presented with progressive leg, scrotal, and abdominal swelling, and shortness of breath. He denied any gastrointestinal symptoms. His lymphedema had initially been diagnosed as chronic filariasis due to positive blood tests for anti-filarial antibodies; however, treatment with anti-filarial drugs failed to improve his symptoms. Subsequently, he underwent surgical lymphaticovenular anastomosis with scrotal reduction, which proved to be of limited symptomatic relief. Later investigations revealed bilateral chylothorax and chylous ascites, with the presence of metastatic adenocarcinoma. Histopathological examination of the patient's skin and scrotum biopsy from his previous surgery revealed invasion of the lymphatics by neoplastic cells with signet ring cell formation. Gastroscopy uncovered a gastric mass, and biopsy confirmed the diagnosis of stage IV gastric adenocarcinoma with signet ring cell. He later received palliative chemotherapy. For the management of chyle leakage, he was prescribed a very low-fat diet and supplemented with parenteral nutrition. Despite treatment, he developed cutaneous metastasis and was transitioned to best supportive care. The patient passed away 14 months after diagnosis.
Identifiants
pubmed: 37737943
doi: 10.1007/s12328-023-01851-5
pii: 10.1007/s12328-023-01851-5
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
822-828Informations de copyright
© 2023. Japanese Society of Gastroenterology.
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