Nishioka Kiyonori, Arai Kuniyoshi, Iwasaki Yoshiaki, Katayanagi Soh, Takahashi Keiichi, Yamaguchi Tatsuro, Matsumoto Hiroshi, Miyamoto Hidenori, Horiguchi Shinichiro
Dept. of Surgery, Tokyo Metropolitan Komagome Hospital.
Gan To Kagaku Ryoho. 2003 Oct;30(11):1839-43.
We report 2 patients with metastatic ovarian tumors of gastric origin who underwent oophorectomy with paraaortic and intrapelvic lymph node dissection, and showed a relatively good outcome. Case 1 A 40-year-old female with gastric cancer located in the MULE area underwent total gastrectomy with D3 lymph node dissection on June 2, 1989. Pathological Stage was IIIB and curability was B according to the JGCA classification. In month 56 after surgery, a left ovarian tumor was detected, and bilateral oophorectomy with paraaortic and intrapelvic lymph node dissection was performed. Signet ring cell carcinoma from the stomach was confirmed in both left ovary and lymph node around the left external iliac artery. In month 51 after the oophorectomy, the patient died from carcinomatous peritonitis. Case 2 A 23-year-old female with gastric cancer located in the M area underwent distal gastrectomy with D3 lymph node dissection on November 1, 2000. Pathological Stage was IV and curability was B according to the JGCA classification. In month 19 after surgery, a left ovarian tumor was detected, and left oophorectomy with paraaortic and intrapelvic lymph node dissection was performed. Poorly differentiated adenocarcinoma from the stomach was confirmed in both left ovary and paraaortic lymph nodes. Chemoradiation therapy was performed for the bone metastasis in lumbar vertebra, which was detected in month 4 after the oophorectomy, and partial response was achieved. As of June 2003, no other malignant lesion has been detected.
我们报告2例胃源性转移性卵巢肿瘤患者,她们接受了卵巢切除术及腹主动脉旁和盆腔内淋巴结清扫术,术后效果相对较好。病例1:一名40岁女性,胃癌位于MULE区,于1989年6月2日接受了D3淋巴结清扫的全胃切除术。根据日本胃癌协会(JGCA)分类,病理分期为IIIB期,治愈性为B级。术后第56个月,发现左侧卵巢肿瘤,遂行双侧卵巢切除术及腹主动脉旁和盆腔内淋巴结清扫术。左侧卵巢及左髂外动脉周围淋巴结均确诊为胃印戒细胞癌。卵巢切除术后第51个月,患者死于癌性腹膜炎。病例2:一名23岁女性,胃癌位于M区,于2000年11月1日接受了D3淋巴结清扫的远端胃切除术。根据JGCA分类,病理分期为IV期,治愈性为B级。术后第19个月,发现左侧卵巢肿瘤,遂行左侧卵巢切除术及腹主动脉旁和盆腔内淋巴结清扫术。左侧卵巢及腹主动脉旁淋巴结均确诊为胃低分化腺癌。卵巢切除术后第4个月,发现腰椎骨转移,遂行放化疗,部分缓解。截至2003年6月,未发现其他恶性病变。