Baba Yoshifumi, Ishikawa Shinji, Ikeda Kouei, Honda Shinobu, Miyanari Nobutomo, Iyama Ken-Ichi, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, Japan.
Gastric Cancer. 2007;10(2):135-9. doi: 10.1007/s10120-007-0416-9. Epub 2007 Jun 25.
A 53-year-old Japanese woman with bilateral ovarian tumors consulted our department. Gastroendoscopy disclosed 16 superficial depressed gastric lesions, and the histopathological diagnosis of the biopsy specimens was poorly differentiated adenocarcinoma and signet-ring cell carcinoma. Computed tomography (CT), ultrasonography (US), and positron emission tomography (PET) examinations revealed no other metastasis except for that observed in the ovaries. We performed a total gastrectomy with radical lymph node dissection and bilateral ovarian resection. A postoperative histological examination revealed 43 isolated gastric lesions which were scattered over the entire resected stomach; they were all confined to the mucosa. Cancer cell invasion in the lymphatics was detected only in the submucosal region beneath the main tumor. Both ovarian tumors were diagnosed as metastasis of signet-ring cell carcinoma (Krukenberg tumor). Adjuvant chemotherapy with irinotecan (CPT-11) and low-dose cisplatin (CDDP) was given on an outpatient basis, but 1 year after the surgery, carcinomatous pericarditis occurred. Administration of mitomycin C (MMC) into the pericardial space was performed twice; however, unfortunately, the patient died 13 months after surgery.
一名患有双侧卵巢肿瘤的53岁日本女性前来我院就诊。胃镜检查发现16处胃浅表凹陷性病变，活检标本的组织病理学诊断为低分化腺癌和印戒细胞癌。计算机断层扫描（CT）、超声检查（US）和正电子发射断层扫描（PET）检查显示，除卵巢转移外未发现其他转移灶。我们进行了全胃切除术及根治性淋巴结清扫和双侧卵巢切除术。术后组织学检查发现43个孤立的胃部病变，散在于整个切除的胃中；均局限于黏膜层。仅在主肿瘤下方的黏膜下层检测到癌细胞淋巴管浸润。双侧卵巢肿瘤均诊断为印戒细胞癌转移（库肯勃瘤）。术后门诊给予伊立替康（CPT - 11）和低剂量顺铂（CDDP）辅助化疗，但术后1年发生癌性心包炎。心包腔内注射丝裂霉素C（MMC）2次；然而，不幸的是，患者术后13个月死亡。
