内容紹介
Summary
A 68-year-old female patient presented with advanced gastric cancer and multiple hepatic tumors. Upper GI endoscopy showed a type 3 lesion in the posterior wall of the gastric body. Abdominal computed tomography revealed multiple liver metastases, and staging laparoscopy identified peritoneal dissemination. She was diagnosed with clinical Stage Ⅳ gastric cancer(cT3N2M1H1). She received 3 courses of combined chemotherapy containing S-1 and cisplatin. The therapeutic response was PR. We performed total gastrectomy with D2 lymph node dissection and splenectomy. Histopathological examination revealed no residual cancer cells, indicating pCR. She continued S-1 adjuvant chemotherapy and has remained free from recurrence for 18 months.
要旨
症例は68歳,女性。健診で肝腫瘤を指摘され近医を受診し,胃癌,多発肝転移の診断にて当院紹介となった。上部消化管内視鏡検査で胃体中部後壁に3型腫瘍を認め,胸腹部CT検査で多発肝転移を認めた。また,審査腹腔鏡で大網に腹膜播種結節を認めた。S-1+CDDP療法を3コース施行し病巣の著明な縮小を認めたため,胃全摘術,脾摘術,D2リンパ節郭清を行った。病理組織検査で原発巣はpCRで化学療法の効果判定はGrade 3であった。術後3か月の腹部CT検査で肝転移は消失した。術後18か月経過した現在,S-1内服を継続し厳重な経過観察を行っているが,腫瘍の再発を認めていない。
目次
A 68-year-old female patient presented with advanced gastric cancer and multiple hepatic tumors. Upper GI endoscopy showed a type 3 lesion in the posterior wall of the gastric body. Abdominal computed tomography revealed multiple liver metastases, and staging laparoscopy identified peritoneal dissemination. She was diagnosed with clinical Stage Ⅳ gastric cancer(cT3N2M1H1). She received 3 courses of combined chemotherapy containing S-1 and cisplatin. The therapeutic response was PR. We performed total gastrectomy with D2 lymph node dissection and splenectomy. Histopathological examination revealed no residual cancer cells, indicating pCR. She continued S-1 adjuvant chemotherapy and has remained free from recurrence for 18 months.
要旨
症例は68歳,女性。健診で肝腫瘤を指摘され近医を受診し,胃癌,多発肝転移の診断にて当院紹介となった。上部消化管内視鏡検査で胃体中部後壁に3型腫瘍を認め,胸腹部CT検査で多発肝転移を認めた。また,審査腹腔鏡で大網に腹膜播種結節を認めた。S-1+CDDP療法を3コース施行し病巣の著明な縮小を認めたため,胃全摘術,脾摘術,D2リンパ節郭清を行った。病理組織検査で原発巣はpCRで化学療法の効果判定はGrade 3であった。術後3か月の腹部CT検査で肝転移は消失した。術後18か月経過した現在,S-1内服を継続し厳重な経過観察を行っているが,腫瘍の再発を認めていない。