[Atypical metastasis of stomach carcinoma]

We report a case of unusual metastases from a gastric cancer. In a 66 years old female with bone metastases a breast cancer was diagnosed. The patient was treated by ablative surgery and chemotherapy but died short time later. An autopsy was performed and showed a large signetring cell carcinoma of the stomach. Further a diffuse involvement of the spleen unknown until autopsy was diagnosed. Serial tissue sections of all metastatic localizations were made. Histopathology and immunostaining including oestroprogesterone receptors identified a gastric cancer as the primary malignancy. A review of the recent literature on breast metastases from gastrointestinal tumours, gastric metastases from breast cancer and the problem of second primary malignancies is given. Further we reviewed the occult metastatic spread of the spleen and the importance of splenectomy in case of total gastrectomy.