Hara Yoshihiro, Nakamura Kenichi, Iwagami Shiro, Ogawa Katsuhiro, Sawayama Hiroshi, Iwatsuki Masaaki, Baba Yoshifumi, Miyamoto Yuji, Yoshida Naoya, Baba Hideo
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Surg Case Rep. 2022 May 13;8(1):95. doi: 10.1186/s40792-022-01439-0.
Gastric cancer is relatively prone to metastasis, although distant metastasis is rare during the early stage of disease. Here we report a rare case of schwannoma-associated Virchow metastasis of a patient with early-stage gastric cancer.
A 73-year-old man, diagnosed with early-stage gastric cancer, underwent preoperative scrutiny, and was only suspected to have Virchow metastasis. Owing to atypical metastatic findings, a lymph node biopsy was performed to confirm the diagnosis and to determine the treatment strategy. The pathology results of the biopsy showed a diagnosis of schwannoma, the patient was judged to be surgically resectable, and a laparoscopic gastrectomy was performed to achieve a radical resection. The patient is currently under outpatient observation with no apparent recurrence.
Systemic chemotherapy is generally administered according to the physician's clinical judgment, although the results of a lymph node biopsy contribute to a more curative treatment. When nonspecific metastases are found, it is important to make a reliable diagnosis and to select a treatment that achieves a cure.
胃癌相对容易发生转移,尽管在疾病早期远处转移很少见。在此,我们报告一例早期胃癌患者发生与神经鞘瘤相关的魏尔啸转移的罕见病例。
一名73岁男性,被诊断为早期胃癌,接受了术前检查,仅怀疑有魏尔啸转移。由于转移表现不典型,进行了淋巴结活检以确诊并确定治疗策略。活检病理结果显示诊断为神经鞘瘤,患者被判定可手术切除,遂行腹腔镜胃切除术以实现根治性切除。患者目前正在门诊观察,无明显复发迹象。
尽管淋巴结活检结果有助于更有效的治疗,但全身化疗通常根据医生的临床判断进行。当发现非特异性转移时,做出可靠诊断并选择能够治愈的治疗方法很重要。