A Case of a Surgically Treated Patient With an Other Ogran Metastasis (Adrenal Gland, Liver) of Gastric Cancer, With a Favorable Prognosis

Kamei, Tomotaka; Hasegawa, Hiroshi; Ogiso, Seiji; Murata, Tohru; Nagasawa, Keiichi; Taniai, Hisashi

doi:10.3919/ringe1963.58.815

Cited by 3 publications

(2 citation statements)

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“…Such involvement is considered to occur in the manner of direct invasion or by lymphangitic routes. As for the metachronous metastases to the adrenal gland from gastric cancer, there have been a few resected cases [5,[7][8][9][10].…”

Section: Offprint Requests To: T Kosakamentioning

confidence: 99%

A long surviving case of resected gastric cancer presenting with a synchronous adrenal metastasis

et al. 1999

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Case reportThe patient, a 75-year-old man, consulted us because of epigastric discomfort in February 1993. Upper GI series and gastroscopy revealed a Borrmann 3 gastric tumor in the proximal stomach. Laboratory data showed slight anemia, 10.5 g/dl of hemoglobin, and elevation of tumor markers (174 ng/ml of CA 19-9 and 298 ng/ml of Sialyl Tn). Computed tomography (CT) indicated a giant gastric tumor that invaded the pancreatic tail; the left adrenal gland seemed normal (Fig. 1). He was subjected to a total gastrectomy and a distal pancreatosplenectomy. Although the left adrenal gland was within normal limits in size, it was intraoperatively palpated as a hard mass. Therefore it was also removed during an abdominal paraaortic lymph node dissection.The postoperative course was uneventful. Histopathological examinations revealed that the gastric tumor, which measured 8.7 ϫ 8.5 cm, was predominantly a poorly differentiated adenocarcinoma with scirrhous invasion with a partial component of tubular adenocarcinoma that invaded the pancreas and involved nine lymph nodes [perigastric: #1, #2, #3, #4s, and #4d; along splenic artery: #11(n2)]. The histopathological findings of the left adrenal tumor revealed that there were adenocarcinoma cells nested within the normal adrenal gland and that this was compatible with those of gastric cancer (Fig. 2). At present, 6 years after the operation, the patient is still alive with no evidence of recurrence of cancer. DiscussionAdrenal metastases occur most commonly in patients with kidney, lung, and colon carcinomas. Recently, there have been three articles on adrenalectomy for metastatic carcinomas. Lo et al.[1] performed adrenalectomy in 52 patients with metastatic adrenal carciAbstract: Clinically curable adrenal metastases are rare. We treated a patient with gastric cancer and a synchronous adrenal metastasis who underwent curative resection. Upper GI examinations of a 75-year-old man revealed a Borrmann 3 gastric tumor in the proximal stomach. CT indicated a giant gastric tumor that invaded the pancreatic tail, and the left adrenal gland seemed normal. He was subjected to a total gastrectomy and a distal pancreatosplenectomy. Because a mass was palpated intraoperatively in the left adrenal gland, it was also removed. The gastric tumor was histopathologically a poorly differentiated adenocarcinoma with scirrhous invasion that invaded the pancreas, and the histopathological findings of the left adrenal tumor were compatible with those of gastric cancer. At present, 6 years after the operation, there has been no clear sign of cancer recurrence. It may be rational to excise the left adrenal gland en bloc in patients with serosa-positive Borrmann 3-4 gastric cancer.

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Section: Offprint Requests To: T Kosakamentioning

confidence: 99%

A long surviving case of resected gastric cancer presenting with a synchronous adrenal metastasis

et al. 1999

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“…[1][2][3] Furthermore, α-fetoprotein (AFP)-producing gastric cancers are relatively rare and associated with a higher incidence of liver metastasis, suggested the contrary. Suspecting a primary lung cancer, we performed right middle lobectomy.…”

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confidence: 97%

Long-Term Survival Achieved by Repeated Resections of Metachronous Pulmonary and Adrenal Metastases of ?-Fetoprotein-Producing Gastric Cancer: Report of a Case

et al. 2004

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We report a case of long-term survival achieved by repeated resections of metastases from alpha-fetoprotein (AFP)-producing gastric cancer. A 59-year-old man initially underwent total gastrectomy with lymph node dissection and resection of the spleen and left adrenal gland, for an advanced AFP-producing gastric cancer. A solitary pulmonary metastasis was resected 2 years later, and then a right adrenal gland metastasis, an inferior vena cava thrombus, and another pulmonary metastasis were resected 6 months, 1 year, and 8 months after each other, respectively. Thus, the patient has survived for 7 years and no further evidence of disease was found at his last follow-up examination. To the best of our knowledge, this is the first case of AFP-producing gastric cancer resulting in metachronous solitary pulmonary and adrenal gland metastases, but not liver metastasis. We report this case to show that for selected cases, surgical resection of these metastases is feasible and may extend survival.

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Resection after Chemotherapy for Anastomotic Recurrence after Total Gastrectomy in Two Gastric Cancer Cases

Shinohara

Hiramatsu

Kato

et al. 2015

Jpn J Gastroenterol Surg, Nihon Shokaki Geka Gakkai zasshi

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胃癌の再発は systemic disease の一形態ととらえられ，これまで外科治療の対象とされてこなかったが，近年化学療法の進歩に伴い，stage IV 胃癌，特に胃癌肝転移に対して手術治療を行い比較的良好な結果を得ている報告もある 1) ．胃癌術後吻合部再発は局所再発の一部にあたり，比較的まれな再発形式であるが 2) ，腹膜播種などと比べて比較的予後が良く 3) ，手術により狭窄症状が改善したという報告や 4) ，長期生存を認めたという報告もある 5) ．根治性を求めるには化学療法の併用が必要と考えられるが，化学療法を行うタイミングについてははっきりとしたものはない．今回，我々は再手術前に化学療法を行い良好な経過をたどった 2 例を経験した．症例症例 1：64 歳，男性主訴：嚥下困難既往歴：特記事項なし．現病歴：2010 年 12 月，U 領域の 4 型胃癌に対して胃全摘術を施行した．CY1 であったため脾臓を温存する D1+郭清とし，結腸後経路で Roux-en Y 再建を行った．切除標本の病理組織学的検査所見は，por2， T4a(SE) ，INFb，ly3，v1，N3，PM0(25 mm) ，DM0(160 mm) ，CY1 となり R1 切除となった(Fig.

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A Case of a Surgically Treated Patient With an Other Ogran Metastasis (Adrenal Gland, Liver) of Gastric Cancer, With a Favorable Prognosis

Cited by 3 publications

References 0 publications

A long surviving case of resected gastric cancer presenting with a synchronous adrenal metastasis

A long surviving case of resected gastric cancer presenting with a synchronous adrenal metastasis

Long-Term Survival Achieved by Repeated Resections of Metachronous Pulmonary and Adrenal Metastases of ?-Fetoprotein-Producing Gastric Cancer: Report of a Case

Resection after Chemotherapy for Anastomotic Recurrence after Total Gastrectomy in Two Gastric Cancer Cases

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