癌性心膜炎にて発症した胃癌切除術後再発の１例

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  • A recurrent case of gastric cancer presented with carcinomatous pericarditis.

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A 51-year-old man performed a distal gastrectomy with D2 lymph node dissection for gastric cancer 2 years earlier was referred to the hospital because of general fatigue. The laboratory data revealed liver dysfunction. Ultrasound cardiography showed significant pericardial effusion and heart failure due to cardiac tamponade. Pericardial drainage was performed and carcinomatous pericarditis was revealed from a cytology. Adjuvant chemotherapy (TS-1: 100mg/day p.o.×4 weeks) was started after the pericardial drainage and pericardial effusion was controlled. Six months later bilateral pleural effusion and dyspnea were recognized. Thoracic drainage offered the diagnosis of bilateral carcinomatous pleuritis. For left pleural effusion which could not be controlled, pleural adhesion therapy by OK432 was conducted. Four months later, right pleural effusion became significant and uncontrolled. The patient died three years later after the resection of gastric primary lesion. Autopsy revealed prominent carcinomatous lymphangitis in the abdominal and thoracic paraaortic region without other abdominal and distant organ metastasis.

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