Rectal resection for Schnitzler’s metastasis in a patient presenting with severe rectal stenosis: case report and review of the literature

Abstract

Rectal metastasis resulting from the hematogenous spread of gastric cancer (Schnitzler’s disease) is rarelyseen. We report a case of 53-year-old female with rectal metastasis from gastic cancer who presented withabdominal pain, tenesmus, and severe constipation. Digital rectal examination revealed a severe stenosis 5-6cm from the dentate line. Sigmoidoscopy showed a narrowed lumen at 5 cm up from the dentate line. Theevident radiologic finding was circumferential stenosis of the rectum located at the same level. Very low anteriorresection and total mesorectal excision with coloanal anastomosis in addition to protective ileostomy wereperformed. Pathological examination revealed metastatic adenocarcinoma (Schnitzler’s metastasis). The patientwas discharged on the 9th postoperative day with no adverse events. It should be kept in mind that rectal stenosiscould be metastasis from gastric carcinoma if consistent with the patient’s history.