Sunagawa Hiroki, Inamine Susumu, Zaha Hisamitsu, Takeshima Masanori, Miyata Michio
Department of Surgery, Nakagami Hospital, Okinawa, Japan.
Surg Today. 2008;38(5):445-8. doi: 10.1007/s00595-007-3656-8. Epub 2008 Apr 30.
We herein describe the case of a patient with advanced gastric carcinoma combined with extra-adrenal pheochromocytoma who received a radical operation after undergoing neoadjuvant chemotherapy. A 48-year-old woman was referred to our hospital for gastric carcinoma. Computed tomography revealed an enlargement of the regional lymph nodes and a para-aortic lymph node. A diagnosis of advanced gastric carcinoma was made (cT3, cN3, cM0, cStage IV according to the Japanese Classification of Gastric Carcinoma, 2nd English edition). A reduction in size was observed in both the gastric tumor and the lymph nodes around the stomach after neoadjuvant chemotherapy. However, the paraaortic lymph node showed no remarkable change. We thus suspected this para-aortic tumor not to be a lymph node, but instead to be an extra-adrenal pheochromocytoma, because of the different response from the other regional lymph nodes. An endocrinological examination confirmed the diagnosis of extra-adrenal pheochromocytoma. A gastrectomy and a resection of the pheochromocytoma were thus performed.
我们在此描述一例晚期胃癌合并肾上腺外嗜铬细胞瘤患者，该患者在接受新辅助化疗后接受了根治性手术。一名48岁女性因胃癌转诊至我院。计算机断层扫描显示区域淋巴结和主动脉旁淋巴结肿大。根据日本胃癌分类第2版英文版，诊断为晚期胃癌（cT3、cN3、cM0、c期IV）。新辅助化疗后，胃肿瘤和胃周围淋巴结均出现缩小。然而，主动脉旁淋巴结未见明显变化。因此，由于该主动脉旁肿瘤与其他区域淋巴结的反应不同，我们怀疑其不是淋巴结，而是肾上腺外嗜铬细胞瘤。内分泌检查确诊为肾上腺外嗜铬细胞瘤。因此，进行了胃切除术和嗜铬细胞瘤切除术。
