A Case of Protein Losing Gastric Cancer Accompanying Pleural Effusion

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  • 胸水を伴った蛋白漏出性胃癌の1例
  • 症例 胸水を伴った蛋白漏出性胃癌の1例
  • ショウレイ キョウスイ オ トモナッタ タンパク ロウシュツセイ イガン ノ 1レイ

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Abstract

A 78-year-old woman was presented with leg edema and weight loss. Her serum total protein and albumin concentrations were 3.5 g/dl and 2.1g/dl, respectively. Computed tomography (CT) showed a gastric tumor and pleural effusion. A gastrofiberscope revealed cauliflower-like type 1 gastric cancer. A leakage of albumin into the alimentary tract was confirmed by 99mTc-HSA scintigraphy. As a result, the lesion was diagnosed as a protein losing gastric cancer. She underwent a distal gastrectomy and D2 lymph node dissection 17 days after her first visit to our hospital, without any preoperative replacement of albumin. Macroscopically, the lesion was 10.7 × 7.0 × 1.2 cm in size. Histologically, the lesion was moderately differentiated adenocarcinoma, pT2(SS), pN1,cH0, P0, CY0, M0, Stage II. Administrations of albumin solution immediately after the operation contributed to an increase in her albumin concentration. The patient's postoperative course was uneventful. Along with the albumin increase, pleural effusion diminished. She was discharged and scheduled for outpatient follow-up. An earlier surgical intervention is strongly recommended for the patients with protein losing gastric cancer, even in a deteriorated condition.

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