Onoyama Haruna, Iwasaki Yoshiaki, Ohashi Manabu, Iwanaga Tomohiro, Ohinata Ryouki, Maeda Yoshiharu, Omuro Yasushi, Sasaki Eisaku, Shimoyama Tatsu, Tateishi Yoko
Dept. of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2131-3.
A 74-year-old man, whose chief complaint was epigastralgia, was referred to our hospital and diagnosed gastric cancer with liver metastasis. Gastrointestinal endoscopy showed a tumor on the lesser curvature of cardia of stomach. He was diagnosed as neuroendocrine cell carcinoma by biopsy specimens. He was treated by combined chemotherapy of CPT-11 and CDDP. After 11 courses, endoscopic examination revealed a complete disappearance of the primary tumor. CT-scan and MRI showed that the liver metastasis had been disappeared. We diagnosed as clinical CR and performed total gastrectomy with lymph node dissection and partial hepatectomy. Histological findings revealed a few cells in stomach and no cancer cells in the liver. He was treated with adjuvant chemotherapy of S-1. After 3-course, he suffered from anemia of grade 3, thus we interrupted chemotherapy. The patient remains alive for 28 months without recurrence. We conclude that chemotherapy was effective for neuroendocrine cell carcinoma of the stomach, which was to be considered of poor prognosis, and that liver resectomy was often effective.
一名74岁男性,主要症状为上腹部疼痛,转诊至我院后被诊断为胃癌伴肝转移。胃肠内镜检查显示胃贲门小弯侧有肿瘤。活检标本诊断为神经内分泌细胞癌。他接受了CPT - 11和顺铂的联合化疗。11个疗程后,内镜检查显示原发肿瘤完全消失。CT扫描和MRI显示肝转移灶已消失。我们诊断为临床完全缓解(CR),并进行了全胃切除加淋巴结清扫和部分肝切除术。组织学检查发现胃内有少量细胞,肝脏内无癌细胞。他接受了S - 1辅助化疗。3个疗程后,他出现3级贫血,因此我们中断了化疗。患者存活28个月无复发。我们得出结论,化疗对预后较差的胃神经内分泌细胞癌有效,肝切除术通常也有效。