Fujisawa Masahiro, Watanobe Ikuo, Machida Michio, Sugo Hiroyuki
Department of General Surgery, Juntendo University Nerima Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2022;119(2):132-138. doi: 10.11405/nisshoshi.119.132.
A woman in her 50s was referred to our hospital with intestinal obstruction. Ten years prior, she had been treated for gastric cancer, pathologically confirmed as stage IIIA poorly differentiated adenocarcinoma with signet-ring cell carcinoma. Intraoperatively, a 4-cm hard white tumor was found in the mesoileum and around the ileum. Pathological examination revealed poorly differentiated adenocarcinoma with signet-ring cell carcinoma and infiltration and fibrosis. Late peritoneal recurrence of gastric carcinoma was diagnosed. Recurrence of gastric carcinoma more than 10 years after curative gastrectomy is extremely rare. A review of 30 cases reported in Japan revealed recurrence was more frequent in females (60%) and the mean age was around 50 years at the time of primary surgery. Poorly differentiated adenocarcinoma and/or signet-ring cell carcinoma was the primary gastric cancer in 82% of cases and bone metastasis was the most frequent site of recurrence.
一名50多岁的女性因肠梗阻被转诊至我院。10年前,她曾接受过胃癌治疗,病理确诊为IIIA期低分化腺癌伴印戒细胞癌。术中,在回肠系膜和回肠周围发现一个4厘米的坚硬白色肿瘤。病理检查显示为低分化腺癌伴印戒细胞癌以及浸润和纤维化。诊断为胃癌晚期腹膜复发。根治性胃切除术后10年以上的胃癌复发极为罕见。对日本报道的30例病例进行回顾发现,复发在女性中更为常见(60%),初次手术时的平均年龄约为50岁。82%的病例中,原发性胃癌为低分化腺癌和/或印戒细胞癌,骨转移是最常见的复发部位。