Cutaneous Metastases from Gastric Cancer Following a Multimodal Radical Therapeutic Approach: A Case Report and Literature Review

Cutaneous Metastases from Gastric Cancer Following a Multimodal Radical Therapeutic Approach: A Case Report and Literature Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Cutaneous Metastases from Gastric Cancer Following a Multimodal Radical Therapeutic Approach: A Case Report and Literature Review YOUSSEF TOUIMRI, imad taleb, Toreis Mehdi, Bazine Aziz, Fetouhi Mohammed This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6247935/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Cutaneous metastases from gastric adenocarcinoma represent a rare and aggressive manifestation, particularly when they occur after radical treatment. This article presents an exceptional case of a 48-year-old man who developed multiple cutaneous metastases just four months after a subtotal gastrectomy and adjuvant chemotherapy for gastric adenocarcinoma. This cutaneous metastatic dissemination, indicative of a particularly aggressive nature, led to the initiation of first-line treatment with trastuzumab and FOLFOX. This case highlights the necessity of heightened vigilance for atypical skin lesions in patients with a history of gastric cancer and underscores the therapeutic challenges associated with this unusual complication. Oncology Cutaneous Metastases Gastric Cancer Multimodal Radical Therapeutic Approach Figures Figure 1 Introduction Gastric adenocarcinoma remains one of the most frequent malignant conditions worldwide. Despite therapeutic advances, distant metastases remain a major cause of morbidity and mortality. Cutaneous metastases, although uncommon, represent a particularly aggressive form of tumor dissemination. Their occurrence after curative treatment is even more singular and poses considerable diagnostic and therapeutic challenges. Early identification of these metastases is crucial for adapting management and optimizing clinical outcomes. This article describes a clinical case of multiple cutaneous metastases in a patient, occurring early after surgery and adjuvant chemotherapy, thus illustrating the aggressiveness of this pathology. Case Report A 48-year-old man, with no significant prior medical history, was diagnosed with poorly cohesive gastric adenocarcinoma, initially classified as T2N1M0. The patient had received perioperative chemotherapy with four cycles of FLOT, followed by a subtotal gastrectomy and then adjuvant chemotherapy with four additional cycles of FLOT. Four months after completing this treatment, the patient presented with a dorsal nodule, initially suspected to be a lipoma. Excision-biopsy of this nodule revealed a metastasis of gastric adenocarcinoma, with immunohistochemistry demonstrating positive HER2 expression. Concurrently and rapidly, several other cutaneous nodules, ranging from 2 to 5 cm in diameter, appeared on the abdomen, primarily along the surgical scar, the thorax, the neck, and the scalp ( Fig. 1 ) . Imaging confirmed the presence of cutaneous metastases. Bone scintigraphy revealed associated bone metastases. Given this cutaneous and bone metastatic dissemination, and the overexpression of HER2, the patient was started on first-line chemotherapy combining FOLFOX, trastuzumab, and zoledronic acid. Discussion Cutaneous metastases from gastric adenocarcinoma, while their incidence is low, signify an aggressive systemic dissemination of the disease. They are reported in less than 0.7–9% of cases of gastric cancer, with variations across studies and populations [1, 2]. Predominantly observed in men, this aligns with the epidemiological profile of gastric cancer itself [3]. The case presented here, in a 48-year-old patient, is atypical due to the rapid cutaneous dissemination, again highlighting the particularly aggressive nature of the tumor. The molecular mechanisms promoting the migration and implantation of tumor cells in the skin remain partially elucidated. Several pathways are implicated, including hematogenous and lymphatic dissemination, local extension, or iatrogenic implantation [4, 5]. The presence of metastases along the surgical scar, as observed in this patient, suggests local implantation of tumor cells during the surgical procedure or lymphatic propagation. However, cutaneous metastases can also occur remotely from the primary tumor site, resulting from hematogenous dissemination, with a predilection for the scalp, thorax, and abdomen [4]. This topographical distribution was observed in our patient, attesting to systemic propagation. Histopathologically, cutaneous metastases from gastric adenocarcinoma may replicate the morphological characteristics of the primary tumor or exhibit more undifferentiated features [6]. Immunohistochemistry plays a vital role in confirming the gastric origin of the tumor, with the expression of markers such as CK7, CK20, MUC1, and MUC5AC [7], as well as HER2 positivity, the latter being of major therapeutic importance [8]. The median time to the appearance of cutaneous metastases after initial treatment is estimated to be between 1.3 and 14 years [9]. The early onset in our case (4 months) suggests a residual disease refractory to both surgical and chemotherapeutic treatment. This reduced time frame reflects an aggressive tumor progression and supports intensified post-operative surveillance. The prognosis for patients with cutaneous metastases from gastric adenocarcinoma remains poor, with a median survival often less than one year [10]. Factors associated with poor prognosis include delayed diagnosis, the extent of metastases, visceral organ involvement, and poor overall condition [6]. Treatment is primarily palliative, focused on improving the quality of life. It is based on chemotherapy combining platinum salts and fluorouracil [6], often coupled with targeted therapy in cases of HER2 overexpression. Indeed, the TOGA study demonstrated that approximately 20% of gastric cancers overexpress HER2 and that the use of trastuzumab, a monoclonal anti-HER2 antibody, significantly improves the overall survival of these patients when combined with chemotherapy [11]. In some cases, surgical excision of symptomatic cutaneous metastases may be considered. Immunotherapy has shown promising results in improving progression-free survival in patients [12]. Conclusion This case report illustrates the rarity and severity of cutaneous metastases from gastric adenocarcinoma after radical treatment. The rapid and disseminated appearance of skin lesions underscores the aggressiveness of this form of metastatic dissemination. It highlights the importance of heightened clinical vigilance, rapid histological and immunohistochemical diagnosis, and a multidisciplinary approach to optimize survival and quality of life in these patients. Further studies are required to better understand the mechanisms of these metastases and to identify more effective therapeutic approaches. Declarations Consent to participate was obtained from the participant. Conflicts of Interest: The authors of this article declare that they have no conflicts of interest. The authors are solely responsible for the information and writing of this article. Funding: The authors of this article have received no grants or funding for this study from any institutions or educational bodies. Consent: Informed consent was obtained from the patient for this publication and the use of images in this publication. ORCID iD https://orcid.org/0009-0006-7908-3102 References Krathen, R.A. ∙ Orengo, I.F. ∙ Rosen, T. Cutaneous metastasis : a meta-analysis of data South Med J. 2003; 96:164-167 J.W. Wang, C.Y. JChai, Y.C. Su, et al. Cutaneous metastasis from gastric adenocarcinoma: a case report Kaohsiung J. Med. Sci., 21 (2005), pp. 329-332, 10.1016/S1607-551X(09)70130-5 Yang L, Ying X, Liu S, Lyu G, Xu Z, Zhang X, Li H, Li Q, Wang N, Ji J. Gastric cancer: Epidemiology, risk factors and prevention strategies. Chin J Cancer Res. 2020 Dec 31;32(6):695-704. doi: 10.21147/j.issn.1000-9604.2020.06.03. PMID: 33446993; PMCID: PMC7797232. A. Narasimha, H. Kumar Gastric adenocarcinoma deposits presenting as multiple cutaneous nodules: a case report with review of literature Turkish J. Pathol, 28 (1) (2012), p. 83, 10.5146/tjpath.2012.01104 A. Joshi, S.P. Sah Cutaneous metastatic adenocarcinoma Indian J. Dermatol. Venereol. Leprol., 67 (2001), pp. 207-208 Cutaneous metastasis from gastric cancer: Manifestation, diagnosis, treatment and prognosis Yao, G.L. et al. European Journal of Surgical Oncology, Volume 50, Issue 2, 107939 Bayrak R, Haltas H, Yenidunya S. The value of CDX2 and cytokeratins 7 and 20 expression in differentiating colorectal adenocarcinomas from extraintestinal gastrointestinal adenocarcinomas: cytokeratin 7−/20+ phenotype is more specific than CDX2 antibody. Diagn Pathol 2012; 7: 9. Boku N. HER2-positive gastric cancer. Gastric Cancer. 2014 Jan;17(1):1-12. doi: 10.1007/s10120-013-0252-z. Epub 2013 Apr 7. PMID: 23563986; PMCID: PMC3889288. Chen JW, Zheng LZ, Xu DH, Lin W. Extensive cutaneous metastasis of recurrent gastric cancer: A case report. World J Clin Cases. 2021 Aug 6;9(22):6575-6581. doi: 10.12998/wjcc.v9.i22.6575. PMID: 34435028; PMCID: PMC8362582. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7–34. doi: 10.3322/caac.21551. Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687–697. doi: 10.1016/S0140-6736(10)61121-X. Takei, S.; Kawazoe, A.; Shitara, K. The New Era of Immunotherapy in Gastric Cancer. Cancers 2022, 14, 1054. https://doi.org/10.3390/cancers14041054 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6247935","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":430158730,"identity":"8677a432-5a5a-485d-9597-eb7123397282","order_by":0,"name":"YOUSSEF TOUIMRI","email":"data:image/png;base64,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","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"YOUSSEF","middleName":"","lastName":"TOUIMRI","suffix":""},{"id":430158798,"identity":"7e86e709-babc-4b96-9a58-aecac443cf25","order_by":1,"name":"imad taleb","email":"","orcid":"","institution":"Department of Medical Oncology, Mohammed V Military Instruction Hospital of Rabat, Morocco","correspondingAuthor":false,"prefix":"","firstName":"imad","middleName":"","lastName":"taleb","suffix":""},{"id":430158893,"identity":"b6dc7194-194d-473b-b576-0aedf34184e8","order_by":2,"name":"Toreis Mehdi","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Toreis","middleName":"","lastName":"Mehdi","suffix":""},{"id":430158894,"identity":"ff8704ac-ab8c-4062-ab51-c2ebbd79f5b9","order_by":3,"name":"Bazine Aziz","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Bazine","middleName":"","lastName":"Aziz","suffix":""},{"id":430158895,"identity":"824b9853-2cde-482d-9a8b-8f83796bf24d","order_by":4,"name":"Fetouhi Mohammed","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Fetouhi","middleName":"","lastName":"Mohammed","suffix":""}],"badges":[],"createdAt":"2025-03-17 22:57:13","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6247935/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6247935/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":79281659,"identity":"ef55342a-072f-434b-aa9f-50b6eda3f65b","added_by":"auto","created_at":"2025-03-26 13:37:13","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1756633,"visible":true,"origin":"","legend":"\u003cp\u003eAggressive, Widespread Cutaneous Metastasis from Gastric Adenocarcinoma\u003c/p\u003e","description":"","filename":"gastricadenocarcinoma.png","url":"https://assets-eu.researchsquare.com/files/rs-6247935/v1/56cd2f4b6b95a3f5cf86859f.png"},{"id":79282605,"identity":"43d715a7-121b-4d40-92a4-a10c6a04c4ee","added_by":"auto","created_at":"2025-03-26 13:45:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2068295,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6247935/v1/66b45873-046b-42fb-b448-809fd6a6d2e4.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eCutaneous Metastases from Gastric Cancer Following a Multimodal Radical Therapeutic Approach: A Case Report and Literature Review\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eGastric adenocarcinoma remains one of the most frequent malignant conditions worldwide. Despite therapeutic advances, distant metastases remain a major cause of morbidity and mortality. Cutaneous metastases, although uncommon, represent a particularly aggressive form of tumor dissemination. Their occurrence after curative treatment is even more singular and poses considerable diagnostic and therapeutic challenges. Early identification of these metastases is crucial for adapting management and optimizing clinical outcomes. This article describes a clinical case of multiple cutaneous metastases in a patient, occurring early after surgery and adjuvant chemotherapy, thus illustrating the aggressiveness of this pathology.\u003c/p\u003e"},{"header":"Case Report","content":"\u003cp\u003eA 48-year-old man, with no significant prior medical history, was diagnosed with poorly cohesive gastric adenocarcinoma, initially classified as T2N1M0. The patient had received perioperative chemotherapy with four cycles of FLOT, followed by a subtotal gastrectomy and then adjuvant chemotherapy with four additional cycles of FLOT. Four months after completing this treatment, the patient presented with a dorsal nodule, initially suspected to be a lipoma. Excision-biopsy of this nodule revealed a metastasis of gastric adenocarcinoma, with immunohistochemistry demonstrating positive HER2 expression. Concurrently and rapidly, several other cutaneous nodules, ranging from 2 to 5 cm in diameter, appeared on the abdomen, primarily along the surgical scar, the thorax, the neck, and the scalp \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Imaging confirmed the presence of cutaneous metastases. Bone scintigraphy revealed associated bone metastases. Given this cutaneous and bone metastatic dissemination, and the overexpression of HER2, the patient was started on first-line chemotherapy combining FOLFOX, trastuzumab, and zoledronic acid.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eCutaneous metastases from gastric adenocarcinoma, while their incidence is low, signify an aggressive systemic dissemination of the disease. They are reported in less than 0.7\u0026ndash;9% of cases of gastric cancer, with variations across studies and populations [1, 2]. Predominantly observed in men, this aligns with the epidemiological profile of gastric cancer itself [3]. The case presented here, in a 48-year-old patient, is atypical due to the rapid cutaneous dissemination, again highlighting the particularly aggressive nature of the tumor.\u003c/p\u003e \u003cp\u003eThe molecular mechanisms promoting the migration and implantation of tumor cells in the skin remain partially elucidated. Several pathways are implicated, including hematogenous and lymphatic dissemination, local extension, or iatrogenic implantation [4, 5]. The presence of metastases along the surgical scar, as observed in this patient, suggests local implantation of tumor cells during the surgical procedure or lymphatic propagation. However, cutaneous metastases can also occur remotely from the primary tumor site, resulting from hematogenous dissemination, with a predilection for the scalp, thorax, and abdomen [4]. This topographical distribution was observed in our patient, attesting to systemic propagation.\u003c/p\u003e \u003cp\u003eHistopathologically, cutaneous metastases from gastric adenocarcinoma may replicate the morphological characteristics of the primary tumor or exhibit more undifferentiated features [6]. Immunohistochemistry plays a vital role in confirming the gastric origin of the tumor, with the expression of markers such as CK7, CK20, MUC1, and MUC5AC [7], as well as HER2 positivity, the latter being of major therapeutic importance [8].\u003c/p\u003e \u003cp\u003eThe median time to the appearance of cutaneous metastases after initial treatment is estimated to be between 1.3 and 14 years [9]. The early onset in our case (4 months) suggests a residual disease refractory to both surgical and chemotherapeutic treatment. This reduced time frame reflects an aggressive tumor progression and supports intensified post-operative surveillance.\u003c/p\u003e \u003cp\u003eThe prognosis for patients with cutaneous metastases from gastric adenocarcinoma remains poor, with a median survival often less than one year [10]. Factors associated with poor prognosis include delayed diagnosis, the extent of metastases, visceral organ involvement, and poor overall condition [6]. Treatment is primarily palliative, focused on improving the quality of life. It is based on chemotherapy combining platinum salts and fluorouracil [6], often coupled with targeted therapy in cases of HER2 overexpression. Indeed, the TOGA study demonstrated that approximately 20% of gastric cancers overexpress HER2 and that the use of trastuzumab, a monoclonal anti-HER2 antibody, significantly improves the overall survival of these patients when combined with chemotherapy [11]. In some cases, surgical excision of symptomatic cutaneous metastases may be considered. Immunotherapy has shown promising results in improving progression-free survival in patients [12].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis case report illustrates the rarity and severity of cutaneous metastases from gastric adenocarcinoma after radical treatment. The rapid and disseminated appearance of skin lesions underscores the aggressiveness of this form of metastatic dissemination. It highlights the importance of heightened clinical vigilance, rapid histological and immunohistochemical diagnosis, and a multidisciplinary approach to optimize survival and quality of life in these patients. Further studies are required to better understand the mechanisms of these metastases and to identify more effective therapeutic approaches.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eConsent to participate was obtained from the participant.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u0026nbsp;\u003c/strong\u003eThe authors of this article declare that they have no conflicts of interest. The authors are solely responsible for the information and writing of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThe authors of this article have received no grants or funding for this study from any institutions or educational bodies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent:\u0026nbsp;\u003c/strong\u003eInformed consent was obtained from the patient for this publication and the use of images in this publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eORCID iD\u003c/strong\u003e https://orcid.org/0009-0006-7908-3102\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKrathen, R.A. ∙ Orengo, I.F. ∙ Rosen, T. Cutaneous metastasis : a meta-analysis of data South Med J. 2003; 96:164-167\u003c/li\u003e\n\u003cli\u003eJ.W. Wang, C.Y. JChai, Y.C. Su, et al. Cutaneous metastasis from gastric adenocarcinoma: a case report Kaohsiung J. Med. Sci., 21 (2005), pp. 329-332, 10.1016/S1607-551X(09)70130-5\u003c/li\u003e\n\u003cli\u003eYang L, Ying X, Liu S, Lyu G, Xu Z, Zhang X, Li H, Li Q, Wang N, Ji J. Gastric cancer: Epidemiology, risk factors and prevention strategies. Chin J Cancer Res. 2020 Dec 31;32(6):695-704. doi: 10.21147/j.issn.1000-9604.2020.06.03. PMID: 33446993; PMCID: PMC7797232.\u003c/li\u003e\n\u003cli\u003eA. Narasimha, H. Kumar Gastric adenocarcinoma deposits presenting as multiple cutaneous nodules: a case report with review of literature Turkish J. Pathol, 28 (1) (2012), p. 83, 10.5146/tjpath.2012.01104\u003c/li\u003e\n\u003cli\u003eA. Joshi, S.P. Sah Cutaneous metastatic adenocarcinoma Indian J. Dermatol. Venereol. Leprol., 67 (2001), pp. 207-208\u003c/li\u003e\n\u003cli\u003eCutaneous metastasis from gastric cancer: Manifestation, diagnosis, treatment and prognosis Yao, G.L. et al. European Journal of Surgical Oncology, Volume 50, Issue 2, 107939\u003c/li\u003e\n\u003cli\u003eBayrak R, Haltas H, Yenidunya S. The value of CDX2 and cytokeratins 7 and 20 expression in differentiating colorectal adenocarcinomas from extraintestinal gastrointestinal adenocarcinomas: cytokeratin 7\u0026minus;/20+ phenotype is more specific than CDX2 antibody. Diagn Pathol 2012; 7: 9.\u003c/li\u003e\n\u003cli\u003eBoku N. HER2-positive gastric cancer. Gastric Cancer. 2014 Jan;17(1):1-12. doi: 10.1007/s10120-013-0252-z. Epub 2013 Apr 7. PMID: 23563986; PMCID: PMC3889288.\u003c/li\u003e\n\u003cli\u003eChen JW, Zheng LZ, Xu DH, Lin W. Extensive cutaneous metastasis of recurrent gastric cancer: A case report. World J Clin Cases. 2021 Aug 6;9(22):6575-6581. doi: 10.12998/wjcc.v9.i22.6575. PMID: 34435028; PMCID: PMC8362582.\u003c/li\u003e\n\u003cli\u003eSiegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7\u0026ndash;34. doi: 10.3322/caac.21551.\u003c/li\u003e\n\u003cli\u003eBang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687\u0026ndash;697. doi: 10.1016/S0140-6736(10)61121-X.\u003c/li\u003e\n\u003cli\u003eTakei, S.; Kawazoe, A.; Shitara, K. The New Era of Immunotherapy in Gastric Cancer. Cancers 2022, 14, 1054. https://doi.org/10.3390/cancers14041054\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Sidi Mohamed Ben Abdellah University Faculty of Medicine and Pharmacy of Fes","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cutaneous Metastases, Gastric Cancer, Multimodal Radical Therapeutic Approach","lastPublishedDoi":"10.21203/rs.3.rs-6247935/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6247935/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eCutaneous metastases from gastric adenocarcinoma represent a rare and aggressive manifestation, particularly when they occur after radical treatment. This article presents an exceptional case of a 48-year-old man who developed multiple cutaneous metastases just four months after a subtotal gastrectomy and adjuvant chemotherapy for gastric adenocarcinoma. This cutaneous metastatic dissemination, indicative of a particularly aggressive nature, led to the initiation of first-line treatment with trastuzumab and FOLFOX. This case highlights the necessity of heightened vigilance for atypical skin lesions in patients with a history of gastric cancer and underscores the therapeutic challenges associated with this unusual complication.\u003c/p\u003e","manuscriptTitle":"Cutaneous Metastases from Gastric Cancer Following a Multimodal Radical Therapeutic Approach: A Case Report and Literature Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-26 13:37:08","doi":"10.21203/rs.3.rs-6247935/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e002cda6-cd2a-40df-af78-407d9efeb351","owner":[],"postedDate":"March 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":45814464,"name":"Oncology"}],"tags":[],"updatedAt":"2025-03-26T13:37:08+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-26 13:37:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6247935","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6247935","identity":"rs-6247935","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}