[Appearance of extrahepatic lesions in the superior lip and orbit of a patient with liver metastases of gastric cancer following partial response by hepatic arterial infusion chemotherapy].

A 76-year-old man was totally gastrectomized in June, 1996 for advanced gastric cancer. In February, 1997, multiple liver metastases were found by abdominal CT scan, and hepatic arterial infusion chemotherapy was started with 5-FU, EPI and MMC by an implantable reservoir indwelled via the left subclavian artery. This treatment was judged to have led to a partial response because reduced focus size of the liver metastasis was revealed by CT scan and levels of tumor markers decreased significantly. However, metastatic foci were found in the skin of the superior lip and the orbit in December 1997. He was treated with a variety of therapies, but died in January, 1998. Many cases with metastatic hepatic cancer have a poor prognosis because of the appearance of extrahepatic lesions in spite of the fact that a partial response can be obtained by hepatic arterial infusion chemotherapy. The present case was unique since extrahepatic lesions appeared at very rare sites such as the superior lip and the orbit.