内容紹介
Summary
The patient was a 59-year-old man with type 2 advanced gastric cancer in the antrum. Abdominal computed tomography revealed the primary tumor with regional lymph node metastasis. Distal gastrectomy and D2 lymph node dissection were performed. Histopathological findings indicated gastric small cell carcinoma. Lymph node metastasis was observed microscopically in the #6 lymph nodes. Peritoneal lavage cytology was positive. The pathologic stage of the disease was pT2(MP), med, INF b, ly2, v2, pPM0, pDM0, pN2(6/33: #5, #6), M1, P0, CY1, H0, stage Ⅳ, R1(cy+). After surgery, he received chemotherapy with capecitabine plus oxaliplatin. However, after 1 course of therapy the disease had progressed, and the patient was diagnosed with peritoneal metastasis. Chemotherapy of CDDP plus CPT-11 was initiated, and after 5 courses the patient died.
要旨
症例は59歳,男性。前庭部に2型進行胃癌を認めた。腹部造影CT検査では胃前庭部に壁肥厚を認め,周囲リンパ節に転移を疑う所見を認めた。開腹幽門側胃切除術,D2,BillrothⅠ法再建を行った。術後病理診断で胃小細胞癌と診断され,#6リンパ節に転移を認めた。腹腔洗浄細胞診でclass Ⅴと診断され,胃癌,L,Ant,type 2,30×25 mm,endocrine carcinoma,small cell carcinoma,pT2(MP),med,INF b,ly2,v2,pPM0,pDM0,pN2(6/33: #5,#6),M1,P0,CY1,H0,stage Ⅳ,R1(cy+)となった。術後,CapeOX療法を1コース行うもCEAが急上昇し,CT検査で腹膜播種の出現を認めた。術後3か月,CDDP+CPT-11療法を開始し5コースまで施行したがPDとなり,術後1年で死亡した。
目次
The patient was a 59-year-old man with type 2 advanced gastric cancer in the antrum. Abdominal computed tomography revealed the primary tumor with regional lymph node metastasis. Distal gastrectomy and D2 lymph node dissection were performed. Histopathological findings indicated gastric small cell carcinoma. Lymph node metastasis was observed microscopically in the #6 lymph nodes. Peritoneal lavage cytology was positive. The pathologic stage of the disease was pT2(MP), med, INF b, ly2, v2, pPM0, pDM0, pN2(6/33: #5, #6), M1, P0, CY1, H0, stage Ⅳ, R1(cy+). After surgery, he received chemotherapy with capecitabine plus oxaliplatin. However, after 1 course of therapy the disease had progressed, and the patient was diagnosed with peritoneal metastasis. Chemotherapy of CDDP plus CPT-11 was initiated, and after 5 courses the patient died.
要旨
症例は59歳,男性。前庭部に2型進行胃癌を認めた。腹部造影CT検査では胃前庭部に壁肥厚を認め,周囲リンパ節に転移を疑う所見を認めた。開腹幽門側胃切除術,D2,BillrothⅠ法再建を行った。術後病理診断で胃小細胞癌と診断され,#6リンパ節に転移を認めた。腹腔洗浄細胞診でclass Ⅴと診断され,胃癌,L,Ant,type 2,30×25 mm,endocrine carcinoma,small cell carcinoma,pT2(MP),med,INF b,ly2,v2,pPM0,pDM0,pN2(6/33: #5,#6),M1,P0,CY1,H0,stage Ⅳ,R1(cy+)となった。術後,CapeOX療法を1コース行うもCEAが急上昇し,CT検査で腹膜播種の出現を認めた。術後3か月,CDDP+CPT-11療法を開始し5コースまで施行したがPDとなり,術後1年で死亡した。