A CASE OF SYNCHRONOUS DOUBLE CANCER OF THE STOMACH AND VERMIFORM APPENDAGE

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  • 虫垂癌,胃癌の同時性2重癌の1例

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Abstract

We reported a patient with synchronous double cancer of the stomach and vermiform appendage, who had been disease-free for 5 years and 9 months after radical operation for both tumors until appendiceal cancer recurred; and further survived 2 years and 3 months after palliative resection of the recurrence. A 72-year-old woman was diagnosed as having advanced gastric cancer by an examination for anemia and underwent a curative resection on November 22, 1988. During the operation, a tumor of the vermiform appendage 3cm in diameter was found. As the intraoperative diagnosis of the gastric cancer was reported as P0T2(SS)N2(+), the appendiceal tumor was diagnosed as primary malignant tumor. Distal gastrectomy with D2 lymphadenectomy and ileocaecal resection with D3 lymphadenectomy were performed. Conclusive diagnosis was gastric cancer with H0P0M0, 3t2(ss)n0, tub2, INFα, med, cur A and appendical cancer with H 0P0M(-), n0, sig, cur A. She was re-admitted to our hospital because of intestinal obstruction in August at 1994 and a CT scan revealed the recurrent nest of the appendiceal cancer at the anastomosis. She underwent a palliative resection of the anastomosis with regional lymphadenectomy (compatible with group 2 lymph nodes). About 2 years later she was admitted for intestinal obstruction due to peritoneal seeding, and died of recurrence of the appendiceal cancer on October 3, 1996. Her performance status just before the last admission was grade 1 or 2. In the treatment of gastric cancer with appendiceal cancer, it is critical to determine whether the appendiceal cancer is primary lesion or metastasis. And it is thought that therapeutic effect of surgical resection can be expected for recurrence of adenocarcinoma of the appendage at the anastomosed site like colorectal cancer.

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