Ozawa Yosuke, Chiba Naokazu, Hikita Kosuke, Okihara Masaaki, Sano Toru, Tomita Koichi, Takano Kiminori, Kawachi Shigeyuki
Dept. of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center.
Gan To Kagaku Ryoho. 2017 Apr;44(4):333-336.
A 56-year-old man with advanced gastric tumor in the pyloric antrum had multiple lymph node metastases(lymph nodes #5, 6, 8, and 13), as revealed by abdominal computed tomography(CT).The patient was diagnosed with coexisting clinical Stage III A gastric cancer(cT2[SS], cN2, cM0)with concomitant malignant lymphoma.Distal gastrectomy, D2 lymph node dissection, and resection of lymph node #13 were performed.Histopathological findings indicated that both the primary tumor and lymph node metastases were neuroendocrine carcinomas.Adjuvant chemotherapy with S-1 was administered; however, follow-up CT after 6 months revealed local recurrence around the celiac artery.Therefore , the chemotherapy regimen was changed to irinotecan and cisplatin.A clinical complete response was obtained after 6 chemotherapy courses and maintained for up to 45 months.The patient is alive at 60 months after the operation.
一名56岁男性，胃幽门窦部患有晚期胃癌，腹部计算机断层扫描（CT）显示有多处淋巴结转移（第5、6、8和13组淋巴结）。该患者被诊断为同时存在临床ⅢA期胃癌（cT2[SS]，cN2，cM0）并伴有恶性淋巴瘤。行远端胃切除术、D2淋巴结清扫术及第13组淋巴结切除术。组织病理学检查结果表明，原发肿瘤和淋巴结转移均为神经内分泌癌。给予S-1辅助化疗；然而，6个月后的随访CT显示腹腔动脉周围局部复发。因此，化疗方案改为伊立替康和顺铂。6个化疗疗程后获得临床完全缓解，并维持长达45个月。患者术后60个月仍存活。
