Department of Gastroenterology, Center Hospital of the National Center for Global Health and Medicine, 1-21-1, Toyoma, Shinjuku-ku, Tokyo, 162-8655, Japan.
Department of Surgery, Center Hospital of the National Center for Global Health and Medicine, 1-21-1, Toyoma, Shinjuku-ku, Tokyo, 162-8655, Japan.
Clin J Gastroenterol. 2023 Jun;16(3):336-343. doi: 10.1007/s12328-023-01786-x. Epub 2023 Mar 25.
A 78-year-old man presented with a large abdominal mass detected by ultrasonography during a regular checkup. Even if the mass was > 10 cm in diameter, he was asymptomatic. Computed tomography detected an oval-shaped mass, with a maximum diameter of 12 cm, adjacent to the greater curvature of the stomach. Esophagogastroduodenoscopy revealed a 20 mm slightly depressed (type 0-IIc) lesion on the posterior wall of the gastric antrum, which was confirmed to be adenocarcinoma. Three cycles of combination chemotherapy with S-1 and oxaliplatin were administered as neoadjuvant chemotherapy. After neoadjuvant chemotherapy, the patient underwent distal gastrectomy, and a histopathological study identified the 12 cm giant mass as a lymph node metastasis. The postoperative course was uneventful, and thus far, the patient has completed adjuvant chemotherapy without relapse. Cases of gastric cancer with a giant lymph node metastasis are extremely rare. In this study, we report the present case and review the previous literature.
一位 78 岁男性在定期体检时通过超声检查发现一个巨大的腹部肿块。尽管肿块直径大于 10cm，但他没有任何症状。计算机断层扫描发现一个椭圆形肿块，最大直径为 12cm，位于胃大弯附近。食管胃十二指肠镜检查显示胃窦后壁有一个 20mm 的轻微凹陷（0-IIc 型）病变，经证实为腺癌。患者接受了三个周期的 S-1 和奥沙利铂联合化疗作为新辅助化疗。新辅助化疗后，患者接受了远端胃切除术，组织病理学研究发现 12cm 巨大肿块为淋巴结转移。术后过程顺利，迄今为止，患者已完成辅助化疗且无复发。胃癌伴巨大淋巴结转移的病例极为罕见。本研究报告了该病例，并复习了以往的文献。
