Shibayama Ryo, Shimoyama Hayato, Kono Kei, Takazawa Yutaka, Ueno Masaki
Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, JPN.
Department of Pathology, Toranomon Hospital, Tokyo, JPN.
Cureus. 2025 Jul 25;17(7):e88730. doi: 10.7759/cureus.88730. eCollection 2025 Jul.
Proximal gastrectomy (PG) is performed in Japan for early-stage gastric cancer in the upper stomach using various reconstruction methods. Although the location and frequency of lymph node metastasis in natural esophagogastric junction cancers have been widely discussed, lymph node metastasis of local recurrence to the esophagogastric anastomosis after PG has not been reported. We present the case of a 77-year-old man who underwent laparoscopic PG for early-stage gastric adenocarcinoma. Local recurrence was detected at the esophageal residual gastric anastomosis two years later. Positron emission tomography/computed tomography revealed suspected cervical lymph node metastasis. Intraoperative rapid histopathology confirmed adenocarcinoma, prompting esophagogastrectomy with three-field lymph node dissection. This report is the first to document cervical lymph node metastasis arising from local recurrence at the esophageal residual gastric anastomosis following PG.
在日本，近端胃切除术（PG）用于治疗胃上部的早期胃癌，采用多种重建方法。尽管天然食管胃交界癌的淋巴结转移部位和频率已得到广泛讨论，但PG术后食管胃吻合口局部复发的淋巴结转移尚未见报道。我们报告一例77岁男性，因早期胃腺癌接受腹腔镜PG手术。两年后在食管残胃吻合口发现局部复发。正电子发射断层扫描/计算机断层扫描显示疑似颈部淋巴结转移。术中快速组织病理学确诊为腺癌，遂行食管胃切除术并进行三野淋巴结清扫。本报告首次记录了PG术后食管残胃吻合口局部复发导致的颈部淋巴结转移。
