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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.


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Histology of metastatic adenocarcinoma showing a glandular pattern with luminal necrosis (H&E, × 40).
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Figure 5: Histology of metastatic adenocarcinoma showing a glandular pattern with luminal necrosis (H&E, × 40).

Mentions: The patient was followed-up regularly, and a hepatic metastasis was diagnosed 15 months postoperatively. Abdominopelvic CT revealed a 3.5-cm low attenuation lesion in the dome of the liver and a second 1-cm lesion in segment 8 of the liver (Fig. 3). Positron emission tomography-computed tomography (PET-CT) failed to demonstrate any other metastatic disease, except in the liver (Fig. 4). Ultrasound-guided needle biopsy (TSK ACECUT biopsy needle; TSK Laboratory, Tochigi, Japan) of the liver lesions confirmed the diagnosis of a metastatic poorly differentiated adenocarcinoma. The patient underwent right anterior sectionectomy of the liver, and the specimen contained both lesions identified by imaging. Histopathological examination confirmed the diagnosis of two foci of metastatic adenocarcinoma consistent with a gastric primary (Fig. 5). Immunohistochemical analysis of the lesion demonstrated the presence of HER2. 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.


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)

Histology of metastatic adenocarcinoma showing a glandular pattern with luminal necrosis (H&E, × 40).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Histology of metastatic adenocarcinoma showing a glandular pattern with luminal necrosis (H&E, × 40).
Mentions: The patient was followed-up regularly, and a hepatic metastasis was diagnosed 15 months postoperatively. Abdominopelvic CT revealed a 3.5-cm low attenuation lesion in the dome of the liver and a second 1-cm lesion in segment 8 of the liver (Fig. 3). Positron emission tomography-computed tomography (PET-CT) failed to demonstrate any other metastatic disease, except in the liver (Fig. 4). Ultrasound-guided needle biopsy (TSK ACECUT biopsy needle; TSK Laboratory, Tochigi, Japan) of the liver lesions confirmed the diagnosis of a metastatic poorly differentiated adenocarcinoma. The patient underwent right anterior sectionectomy of the liver, and the specimen contained both lesions identified by imaging. Histopathological examination confirmed the diagnosis of two foci of metastatic adenocarcinoma consistent with a gastric primary (Fig. 5). Immunohistochemical analysis of the lesion demonstrated the presence of HER2. 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.

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