51 year-old male who had undergone total gastrectomy with splenectomy 4 years ago was admitted to our hospital for examination and treatment for melena. Type 4 tumors were found in the vermiform appendix and the rectum by endoscopic examination. Histopathological fingings showed signet ring cell carcinoma similar to that of the gastric cancer. Therefore it was diagnosed as metastatic diffuse infiltrative type 4 carcinoma of the appendix and rectum. Lymphangio-metastasis and peritoneal dissemination of the gastric cancer was determined negative in relation by pre- and opelative examination. Therefore hematogenous metastasis of the signet ring cell carcinoma from the original gastric cancer through SMA for the appendix and IMA for the rectal lesions were most suspected for the route of metastasis.
A rare case of gastric cancer with hematogenous metastasis to the appendix and rectum is reported.