Kim Sang Hyun, Kim Dong Jin, Kim Wook
Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Gastric Cancer. 2015 Sep;15(3):209-13. doi: 10.5230/jgc.2015.15.3.209. Epub 2015 Sep 30.
A 78-year-old man underwent laparoscopy-assisted total gastrectomy for gastric cancer (pT3N0M0). Multiple port sites were used, including a 10 mm port for a videoscope at the umbilical point and three other working ports. During the six-month follow-up evaluation, a 2 cm enhancing mass confined to the muscle layer was found 12 mm from the right lower quadrant port site, suggesting a metastatic or desmoid tumor. Follow-up computed tomography imaging two months later showed that the mass had increased in size to 3.5 cm. We confirmed that there was no intra-abdominal metastasis by diagnostic laparoscopy and then performed a wide resection of the recurrent mass. The histologic findings revealed poorly differentiated adenocarcinoma, suggesting a metastatic mass from the stomach cancer. The postoperative course was uneventful, and the patient completed adjuvant chemotherapy with TS-1 (tegafur, gimeracil, and oteracil potassium). There was no evidence of tumor recurrence during the 50-month follow-up period.
一名78岁男性因胃癌(pT3N0M0)接受了腹腔镜辅助全胃切除术。使用了多个端口部位,包括脐部用于视频内窥镜的10毫米端口和其他三个操作端口。在六个月的随访评估中,在右下象限端口部位12毫米处发现一个2厘米的强化肿块,局限于肌肉层,提示为转移性或硬纤维瘤样肿瘤。两个月后的随访计算机断层扫描成像显示肿块大小增加到3.5厘米。我们通过诊断性腹腔镜检查确认没有腹腔内转移,然后对复发性肿块进行了广泛切除。组织学检查结果显示为低分化腺癌,提示为胃癌转移灶。术后过程顺利,患者完成了替吉奥(替加氟、吉美嘧啶和奥替拉西钾)辅助化疗。在50个月的随访期内没有肿瘤复发迹象。