Case Report of Gastric Cancer with Tumor Thrombus Extending into the Portal Vein

Takashi Shirobe, Shuzo Nakamura, Nobutaka Yasui, Masatoshi Ohta, Kazuhiko Yasumura, Youichiro Kakumoto, Yorio Nakagawa

Department of Surgery, Nipponkokan Hospital

A 38-year-old man was admitted to Nipponkokan Hospital with a diagnosis of gastric cancer. At surgery we found a tumor thrombus extending from the superior mesenteric vein to the portal trunk along with gastric cancer. Metastatic lymph nodes in the subpyloric and prepancreatic area were adhering to the pancreas head. The mesocolon was also invaded by cancer. Therefore, pancreatoduodenectomy, resection of the transverse colon and resection of the portal vein were carried out. The resected portal vein was 8 cm in length. End to end anastomosis of the stumps were performed without tension. The patient is alive without signs of recurrence 13 months after surgery. Thus far, 18 patients with gastric cancer with a tumor thrombus in the portal vein have been reported and 4 of them could undergo resection. With the development of imaging technics, this condition is likely to be diagnosed preoperatively. Surgeons should be aware of the possibility of treating such patients.

Key words
gastric cancer, portal vein tumor thrombus

Reprint requests
Takashi Shirobe Department of Surgery, Sano Kosei Hospital
1555 Horigome, Sano, 327 JAPAN

Accepted
November 11, 1992

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