内容紹介
Summary
Here, we report a case of superficial-type gastric cancer with metastatic ovarian cancer(Krukenberg tumor)diagnosed by exploratory laparotomy. Chemotherapy was initiated at an early stage in this patient. A 43-year-old woman with superficial-type gastric cancer(0-Ⅱb plusⅡa), an ovarian tumor, and a solitary sclerotic bone lesion underwent exploratory laparotomy and bilateral salpingo-oophorectomy. Pathological findings showed that the resected ovarian tumor specimen contained the same type of signet ring cell carcinoma as the biopsy gastric cancer specimen; hence, the patient was diagnosed with superficial-type gastric cancer with metastatic ovarian cancer. She was treated with first-line chemotherapy(capecitabine plus oxaliplatin)15 days after exploratory laparotomy, followed by second-line chemotherapy(ramucirumab plus paclitaxel), third-line chemotherapy(nivolumab), and fourth-line chemotherapy(irinotecan). Twenty-two months after the start of first-line chemotherapy, she finally died due to bone metastasis.
要旨
今回われわれは,腹腔鏡下試験開腹術を行うことで表在型胃癌の卵巣転移(クルッケンベルグ腫瘍)を診断し,早期に治療が開始できた症例を経験した。患者は43歳,女性。検診で異常を指摘され当院を受診,精査にて表在型胃癌と両側卵巣腫瘍,孤発性の骨硬化性病変を指摘された。診断確定のため腹腔鏡下試験開腹術を行い,播種がなく,腹水細胞診陰性を確認後,両側付属器切除を行った。卵巣腫瘍が印環細胞癌で胃癌の生検組織と類似することから,胃癌の卵巣転移と診断した。診断確定後,術後15日目から一次化学療法(カペシタビンとオキサリプラチン併用化学療法)を開始した。以降,病状の進行に伴い,二次化学療法(ラムシルマブ,パクリタキセル併用),三次化学療法(ニボルマブ),四次化学療法(イリノテカン)を行ったが骨転移が増悪し,治療開始後1年10か月で原病死した。
目次
Here, we report a case of superficial-type gastric cancer with metastatic ovarian cancer(Krukenberg tumor)diagnosed by exploratory laparotomy. Chemotherapy was initiated at an early stage in this patient. A 43-year-old woman with superficial-type gastric cancer(0-Ⅱb plusⅡa), an ovarian tumor, and a solitary sclerotic bone lesion underwent exploratory laparotomy and bilateral salpingo-oophorectomy. Pathological findings showed that the resected ovarian tumor specimen contained the same type of signet ring cell carcinoma as the biopsy gastric cancer specimen; hence, the patient was diagnosed with superficial-type gastric cancer with metastatic ovarian cancer. She was treated with first-line chemotherapy(capecitabine plus oxaliplatin)15 days after exploratory laparotomy, followed by second-line chemotherapy(ramucirumab plus paclitaxel), third-line chemotherapy(nivolumab), and fourth-line chemotherapy(irinotecan). Twenty-two months after the start of first-line chemotherapy, she finally died due to bone metastasis.
要旨
今回われわれは,腹腔鏡下試験開腹術を行うことで表在型胃癌の卵巣転移(クルッケンベルグ腫瘍)を診断し,早期に治療が開始できた症例を経験した。患者は43歳,女性。検診で異常を指摘され当院を受診,精査にて表在型胃癌と両側卵巣腫瘍,孤発性の骨硬化性病変を指摘された。診断確定のため腹腔鏡下試験開腹術を行い,播種がなく,腹水細胞診陰性を確認後,両側付属器切除を行った。卵巣腫瘍が印環細胞癌で胃癌の生検組織と類似することから,胃癌の卵巣転移と診断した。診断確定後,術後15日目から一次化学療法(カペシタビンとオキサリプラチン併用化学療法)を開始した。以降,病状の進行に伴い,二次化学療法(ラムシルマブ,パクリタキセル併用),三次化学療法(ニボルマブ),四次化学療法(イリノテカン)を行ったが骨転移が増悪し,治療開始後1年10か月で原病死した。