Kobayashi Osamu, Sugiyama Yuka, Konishi Kazuo, Kanari Masahiro, Cho Haruhiko, Tsuburaya Akira, Sairenji Motonori, Motohashi Hisahiko, Yoshikawa Takaki
The Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama 241-0815, Japan.
Gastric Cancer. 2002;5(3):173-6. doi: 10.1007/s101200200030.
Regional lymph node metastasis in advanced gastric cancer is common, whereas axillary lymph node metastasis (ALNM) is rare. We experienced a patient with a solitary ALNM in gastric cancer. A 48-year-old woman underwent curative distal gastrectomy for advanced gastric cancer (P0H0T3N3M0CY0, stage IV). Twenty-one months after the surgery, she complained of an asymptomatic left axillary tumor. Mammography and computed tomography (CT) scans showed the presence of tumors in neither breast nor lung. Fine-needle aspiration of the axillary tumor demonstrated poorly differentiated adenocarcinoma cells, which coincided with the cells of the resected gastric carcinoma. We diagnosed ALNM from gastric cancer and operated on the patient with radical left axillary lymph node dissection. One year after the reoperation, she has had no recurrence. We conclude that gastric cancer can metastasize to unusual sites. A re-radical resection is recommended if curative resection is feasible.
晚期胃癌区域淋巴结转移很常见，而腋窝淋巴结转移（ALNM）则很少见。我们遇到了一位患有孤立性胃癌腋窝淋巴结转移的患者。一名48岁女性因晚期胃癌（P0H0T3N3M0CY0，IV期）接受了根治性远端胃切除术。术后21个月，她主诉左腋窝有无症状肿物。乳房X线摄影和计算机断层扫描（CT）均未显示乳房或肺部有肿瘤。对腋窝肿物进行细针穿刺，结果显示为低分化腺癌细胞，与切除的胃癌细胞一致。我们诊断为胃癌腋窝淋巴结转移，并对患者进行了根治性左腋窝淋巴结清扫术。再次手术后一年，她没有复发。我们得出结论，胃癌可转移至不常见部位。如果可行根治性切除，建议再次进行根治性切除。
