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Metachronous Liver Metastasis Resulting from Early Gastric Carcinoma after Subtotal Gastrectomy Following Endoscopic Resection: A Case Report.

Oh SJ, Suh BJ - J Gastric Cancer (2015)

Bottom Line: Histology of the resected specimen confirmed the diagnosis of two foci of metastatic adenocarcinoma originating from stomach cancer.The patient was treated with trastuzumab in combination with chemotherapy consisting of capecitabine and cisplatin.Twenty-four months after the operation, the patient remained free of recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT
Hepatic metastasis of early gastric cancer (EGC) following subtotal gastrectomy with lymphadenectomy is rare. We report the case of a 61-year-old male patient who was diagnosed with EGC that was initially treated using endoscopic submucosal dissection (ESD) and subsequently underwent laparoscopic subtotal gastrectomy. Histopathological examination of the patient's ESD specimen showed a moderately differentiated tubular adenocarcinoma invading the submucosa without lymphatic invasion. The deep margin of the specimen was positive for adenocarcinoma, and he subsequently underwent laparoscopic distal gastrectomy. The patient developed liver metastasis 15 months after the operation and then underwent liver resection. Histology of the resected specimen confirmed the diagnosis of two foci of metastatic adenocarcinoma originating from stomach cancer. Immunohistochemical analysis of the specimen demonstrated overexpression of human epidermal growth factor receptor 2. The patient was treated with trastuzumab in combination with chemotherapy consisting of capecitabine and cisplatin. Twenty-four months after the operation, the patient remained free of recurrence.

No MeSH data available.


Related in: MedlinePlus

Esophagogastroduodenoscopy showing a small superficial elevated lesion in the antrum of the stomach.
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Figure 1: Esophagogastroduodenoscopy showing a small superficial elevated lesion in the antrum of the stomach.

Mentions: Esophagogastroduodenoscopy revealed a 1.7-cm superficially elevated (IIa)-type of EGC in the gastric antrum on the lesser curvature (Fig. 1). This lesion was revealed as a moderately differentiated adenocarcinoma on pathological examination. Abdominopelvic computed tomography (CT) showed no evidence of distant metastasis. Given the clinical diagnosis of EGC, ESD was performed by a gastroenterologist. Histopathological examination of the specimen showed a moderately to poorly differentiated adenocarcinoma that invaded the submucosal layer to a depth of 1.5 mm (Fig. 2). The deep margin of the resected specimen had tumor involvement. There was no evidence of lymphatic, venous, or perineural invasion. We therefore performed a laparoscopic distal gastrectomy with lymph node dissection. There was no evidence of residual carcinoma in the resected specimen and no evidence of metastasis in the 38 identified lymph nodes. The postoperative course was uneventful, and the patient was discharged 14 days after the resection.


Metachronous Liver Metastasis Resulting from Early Gastric Carcinoma after Subtotal Gastrectomy Following Endoscopic Resection: A Case Report.

Oh SJ, Suh BJ - J Gastric Cancer (2015)

Esophagogastroduodenoscopy showing a small superficial elevated lesion in the antrum of the stomach.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496441&req=5

Figure 1: Esophagogastroduodenoscopy showing a small superficial elevated lesion in the antrum of the stomach.
Mentions: Esophagogastroduodenoscopy revealed a 1.7-cm superficially elevated (IIa)-type of EGC in the gastric antrum on the lesser curvature (Fig. 1). This lesion was revealed as a moderately differentiated adenocarcinoma on pathological examination. Abdominopelvic computed tomography (CT) showed no evidence of distant metastasis. Given the clinical diagnosis of EGC, ESD was performed by a gastroenterologist. Histopathological examination of the specimen showed a moderately to poorly differentiated adenocarcinoma that invaded the submucosal layer to a depth of 1.5 mm (Fig. 2). The deep margin of the resected specimen had tumor involvement. There was no evidence of lymphatic, venous, or perineural invasion. We therefore performed a laparoscopic distal gastrectomy with lymph node dissection. There was no evidence of residual carcinoma in the resected specimen and no evidence of metastasis in the 38 identified lymph nodes. The postoperative course was uneventful, and the patient was discharged 14 days after the resection.

Bottom Line: Histology of the resected specimen confirmed the diagnosis of two foci of metastatic adenocarcinoma originating from stomach cancer.The patient was treated with trastuzumab in combination with chemotherapy consisting of capecitabine and cisplatin.Twenty-four months after the operation, the patient remained free of recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT
Hepatic metastasis of early gastric cancer (EGC) following subtotal gastrectomy with lymphadenectomy is rare. We report the case of a 61-year-old male patient who was diagnosed with EGC that was initially treated using endoscopic submucosal dissection (ESD) and subsequently underwent laparoscopic subtotal gastrectomy. Histopathological examination of the patient's ESD specimen showed a moderately differentiated tubular adenocarcinoma invading the submucosa without lymphatic invasion. The deep margin of the specimen was positive for adenocarcinoma, and he subsequently underwent laparoscopic distal gastrectomy. The patient developed liver metastasis 15 months after the operation and then underwent liver resection. Histology of the resected specimen confirmed the diagnosis of two foci of metastatic adenocarcinoma originating from stomach cancer. Immunohistochemical analysis of the specimen demonstrated overexpression of human epidermal growth factor receptor 2. The patient was treated with trastuzumab in combination with chemotherapy consisting of capecitabine and cisplatin. Twenty-four months after the operation, the patient remained free of recurrence.

No MeSH data available.


Related in: MedlinePlus