Chang Yeon Soo, Kim Min Sung, Kim Dong Hee, Park Seulkee, You Ji Young, Han Joon Kil, Kim Seong Hwan, Lee Ho Jung
Department of Surgery, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea.
J Gastric Cancer. 2016 Jun;16(2):120-4. doi: 10.5230/jgc.2016.16.2.120. Epub 2016 Jun 24.
Primary squamous cell carcinoma (SCC) of the stomach is a very rare disease. However, the pathogenesis, clinical characteristics, and prognosis of gastric SCC are controversial and remain to be elucidated. Herein, we report a case of primary gastric SCC of the remnant stomach after subtotal gastrectomy. A 65-year-old man was admitted to our hospital due to epigastric discomfort and dizziness. He had undergone subtotal gastrectomy 40 years previously for gastric ulcer perforation. Endoscopy revealed a normal esophagus and a large mass in the remnant stomach. Abdominal computed tomography revealed enhanced wall thickening of the anastomotic site and suspected metachronous gastric cancer. Endoscopic biopsy revealed SCC. Total gastrectomy was performed with Roux-en-Y esophagojejunostomy. A 10-cm tumor was located at the remnant stomach just proximal to the previous area of anastomosis. Pathologic examination showed well-differentiated SCC extended into the subserosa without lymph node involvement (T3N0M0). The patient received adjuvant systemic chemotherapy with 6 cycles of 5-FU and cisplatin regimen, and he is still alive at the 54-month follow-up. According to the treatment principles of gastric cancer, early detection and radical surgical resection can improve the prognosis.
原发性胃鳞状细胞癌（SCC）是一种非常罕见的疾病。然而，胃SCC的发病机制、临床特征和预后仍存在争议，有待阐明。在此，我们报告一例胃大部切除术后残胃原发性胃SCC病例。一名65岁男性因上腹部不适和头晕入住我院。他40年前因胃溃疡穿孔接受了胃大部切除术。内镜检查显示食管正常，残胃有一巨大肿物。腹部计算机断层扫描显示吻合口壁增厚强化，怀疑为异时性胃癌。内镜活检显示为SCC。行全胃切除术并 Roux-en-Y 食管空肠吻合术。一个10厘米的肿瘤位于残胃，恰好在先前吻合口近端。病理检查显示高分化SCC侵犯至浆膜下层，无淋巴结转移（T3N0M0）。患者接受了6周期氟尿嘧啶和顺铂方案的辅助全身化疗，在54个月的随访中仍存活。根据胃癌的治疗原则，早期发现和根治性手术切除可改善预后。
