Paper Title
Endobronchial Metastasis From Gastric Stump Cancer: A Case Report And Review Of The Literature

Abstract
We report a case of EBM from gastric stump cancer and do a brief review of the associated articles. A 59-year-old man who had undergone Billroth II gastrectomy for gastric ulcer was enrolled in our Department of Respiratory Medicine. He was admitted for dry cough and shortness of breath. On admission, a right supraclavicular lymph node, 1.0 cm in diameter, and bilateral pleural effusion were observed upon physical examination. Laboratory tests showed serum carcinoembryonic antigen and CYFRA 21-1 were extremely high, while several abnormal enlarged lymph nodes and bilateral pleural effusion were observed on CT scans. Fibrotic bronchoscopy revealed a spread submucosal infiltration which narrowed the back segment of the left lower lobar bronchus. The biopsy specimen suggested an identical immunohistochemistry to the gastric primitive cancer. Oesophagogastroduodenoscopy found an irregular, exophytic, circumferential and longitudinal tumor mass, of which the biopsied specimen showed poorly differentiated adenocarcinoma. The final diagnosis was EBM secondary to gastric stump cancer. The gastric cancer-derived EBM, although extremely rare, should be included in the differential diagnosis of lymph nodules enlargement and pleural effusion. IndexTerms- Adenocarcinoma; Case Reports, Neoplasm Metastasis; Stomach Neoplasms