Journal of the Formosan Medical Association
Volume 106, Issue 7 , Pages 589-591, 2007

An Unusual Presentation of Metastatic Gastric Adenocarcinoma — Acute Onset of Right Neck Swelling

  • Kuan-Ting Liu

      Affiliations

    • Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung Medical University, Kaohsiung, Taiwan
  • ,
  • Hon-Man Chan

      Affiliations

    • Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Departments of Surgery Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
  • ,
  • Tzeng-Jih Lin

      Affiliations

    • Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Departments of Surgery and Emergency Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Tzeng-Jih Lin, Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan

Received 5 June 2006; received in revised form 20 November 2006; accepted 2 January 2007.

Central venous thrombosis is an uncommon problem associated with malignancy. We present here a 53- year-old male who visited the emergency room because of right neck swelling. Fluid accumulation over deep neck space led to the diagnosis of suspected hemorrhage, and central venous thrombosis was found by computed tomography. This patient had no other precipitating cause. Autoimmune disorders, hypercoagulation and malignancy surveys were performed during hospitalization. Elevated serum tissue polypeptide antigen and CA130 were noted, and multiple liver metastases were found by another computed tomography. Subsequently, gastric adenocarcinoma was confirmed after gastroendoscopy. Gastric adenocarcinoma with distal metastases was finally diagnosed. This case reminds us that central venous thrombosis is a sign of many diseases. Malignancy, including gastric adenocarcinoma, is one of the causes that should be considered.

Key Words:  central vein , gastric cancer , malignancy , thrombosi

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PII: S0929-6646(07)60011-4

doi:10.1016/S0929-6646(07)60011-4

Journal of the Formosan Medical Association
Volume 106, Issue 7 , Pages 589-591, 2007