A Long Surviving Case of Remnant Stomach Cancer with Paraaortic Lymph-node Metastasis -A Patient with Three Primary Cancers Including Remnant Stomach Cancer Gallbladder Cancer and Breast Cancer-

Takeo Kosaka, Shigeru Takegawa, Masashi Kato, Takayoshi Akiyama, Fujio Tomita, Hiroaki Hagihara, Hitoshi Saito, Ichiro Kita, Yasuhiko Kojima, Shigeki Takashima, Yoshio Kinami

Second Department of Surgery, School of Medicine, Kanazawa Medical University

We report a long surviving patient with remnant stomach cancer with paraaortic lymph-node metastasis, who had triple cancers consisting of remnant stomach cancer, gallbladder cancer and breast cancer. In 1987, a 64-year-old woman underwent total excision of the remnant stomach with distal pancreatectomy and splenectomy for a remnant gastric cancer, and an extended cholecystectomy for a gallbladder cancer, simultaneously, and in 1988 she underwent a modified radical mastectomy for right breast cancer. Microscopic findings revealed that the gallbladder cancer was intramucosal and the breast cancer was stage I, t1n0m0. On the other hand, the remnant cancer was stage IV due to paraaortic lymph-node metastasis. However, periodic follow-up has revealed no evidence of disease. Although the prognosis of patients with advanced cancer of the stomach remnant has been reported to be poor, it might be improved by adequate resection accompanied by proper lymph-node dissection according to the stage of each cancer. Also, at the time of examining a patient with cancer, attention should be paid to multiple primary cancers before and after surgery.

Key words
paraaortic lymph-node metastasis, stomach remnant cancer, multiple primary malignant neoplasia

Reprint requests
Takeo Kosaka Second Department of Surgery, School of Medicine, Kanazawa Medical University
1-1, Aza-daigaku, Uchinadamachi, Kahokugun, Ishikawaken, 920-02 JAPAN

Accepted
April 1, 1992

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