A Resected Case of Metachronous Splenic Metastasis from Stage Ⅳ Gastric Cancer

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  • Ebinuma Shota
    Department of Gastroenterological Surgery Ⅰ, Hokkaido University Graduate School
  • Kawamura Hideki
    Department of Gastroenterological Surgery Ⅰ, Hokkaido University Graduate School
  • Yoshida Tadashi
    Department of Gastroenterological Surgery Ⅰ, Hokkaido University Graduate School
  • Ichikawa Nobuki
    Department of Gastroenterological Surgery Ⅰ, Hokkaido University Graduate School
  • Honma Shigenori
    Department of Gastroenterological Surgery Ⅰ, Hokkaido University Graduate School
  • Shimizu Ai
    Department of Surgical Pathology, Hokkaido University Graduate School
  • Taketomi Akinobu
    Department of Gastroenterological Surgery Ⅰ, Hokkaido University Graduate School

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  • Stage Ⅳ進行胃癌の異時性孤立性脾転移に対して脾臓摘出術を施行した１例

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<p>A fifty-year-old man, diagnosed as having stage Ⅳ gastric cancer (metastasis of the para-aortic lymph nodes and left supraclavicular lymph nodes), received nine courses of S-1 plus oxaliplatin. The metastatic lymph nodes decreased in size, and we performed a gastrectomy with a D2 – No. 10 + No. 16a2/b1 lymph node dissection. Histopathological findings showed gastric cancer to Stage ⅡA and he underwent adjuvant chemotherapy with S-1. One year after the first surgery, an abdominal CT scan revealed metastasis to the spleen. The patient received one course of capecitabine plus oxaliplatin and eight courses of paclitaxel plus ramucirumab. After the chemotherapy regimens, the size of the tumor remained stable and the patient underwent a splenectomy. He received postoperative adjuvant chemotherapy and has been alive without relapse. We consider that this is informative for conversion surgery in cases of gastric cancer.</p>

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