Tanda Hideki, Hori Takeshi, Sakimura Chie, Tendo Masashige, Nakata Bunzo, Ishikawa Tetsurou, Hirakawa Kosei
Dept. of Surgery, Kashiwara Municipal Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1865-1866.
Splenic metastasis of gastric cancer is rare. Cases of long-term survival after the resection of metachronous solitary splenic metastasis have been reported, and proactive resection should be performed. A 77-year-old man was presented to our hospital with anorexia. Further investigation showed type 2 gastric cancer in the greater curvature of the stomach in the lower body. Subsequently distal gastrectomy was performed on October 2018. The pathological stage was T3N2M0, Stage ⅢA, and the patient was treated with S-1 as adjuvant chemotherapy for 1 year. Two years after surgery, enhanced computed tomography(CT)showed a solitary splenic tumor with a diameter of 10 mm. Six months later, the tumor had grown to 25 mm, and PET-CT revealed no other tumors. Thus we diagnosed the patient as metachronous solitary splenic metastasis of gastric cancer, and splenectomy was performed on June 2021. Histopathological diagnosis was a metastasis of gastric cancer. The patient was treated with S-1 and remains recurrence-free for 1 year after the second operation.
胃癌的脾转移很少见。有报道称，异时性孤立性脾转移切除术后长期存活的病例，应积极进行切除。一名77岁男性因厌食症前来我院就诊。进一步检查发现胃下半身大弯处有2型胃癌。随后于2018年10月进行了远端胃切除术。病理分期为T3N2M0，ⅢA期，患者接受S-1辅助化疗1年。术后两年，增强计算机断层扫描（CT）显示一个直径10毫米的孤立性脾脏肿瘤。六个月后，肿瘤长到了25毫米，正电子发射断层扫描-CT（PET-CT）未发现其他肿瘤。因此，我们将该患者诊断为胃癌异时性孤立性脾转移，并于2021年6月进行了脾切除术。组织病理学诊断为胃癌转移。患者接受S-1治疗，二次手术后1年无复发。
