化学療法後切除した著明なリンパ節転移を認めた胃内分泌細胞癌の１例

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  • A case of gastric endocrine cell carcinoma with remarkable lymph node metastasis resected after neoadjuvant chemotherapy.

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This paper presents a case of gastric endocrine cell carcinoma with remarkable lymph node metastasis sucsessfully resected after neoadjuvant chomotherapy with a low dose of FP. A 56-year-old woman was admitted to the hospital because of right hypochondralgia. An upper gastrointestinal endoscopy and a barium meal study revealed a submucosal tumor like elevation of the antrum with deep ulceration. Histological examination of biopsied specimens suggested the presence of poorly differentiated adenocarcinoma. An abdominal CT scan revealed a gastric wall thickening and metastasis to regional lymphnode No.6 and 8a. With a diagnosis of gastric cancer the patient underwent a gastrojejunostomy because the tumor was far advanced and seemed to involve the head of the pancreas and portal vein. Then she was treated with chemotherapy with a low dose of CDDP and 5-FU. Because the regional lymph nodes remarkably became small after two cycles of chemotherapy, a distal gastrectomy with D2 lymph node dissection was carried out. Histological diagnosis was endocrine cell carcinoma. One and a half year after the resection, she is doing well, while CT scan revealed recurrence of lymph node metastasis and postoperative chemotherapy is being performed.

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