A Case of Peritoneal Recurrence of Gastric Cancer Early Detected with a Diagnostic Laparoscopy

Osamu Kobayashi, Kazufumi Suzuki, Takaki Yoshikawa, Yasushi Rino, Akira Tsuburaya, Motonori Sairenji, Hisahiko Motohashi

Department of Surgery, Kanagawa Cancer Center Hospital

Diagnosis of the peritoneal recurrence at an early stage is difficult in gastric cancer. Here we report a case of peritoneal recurrence detected early by diagnostic laparoscopy. In September, 1992, curative resection was performed for gastric cancer. Epigastralgia was appeared in February, 1998, 65 months after surgery. Abdominal ultrasonography and computed tomography indicated no abnormal findings except gall stones. The serum concentration of carcinoembryonic antigen was 4.5 ng/ml being slightly elevated. Diagnostic laparoscopy revealed three nodules with the diameter of approximately 2 mm in the Douglas pouch. Macroscopically, an irregular surface and margin and neovascularization were found in two of these nodules, indicating peritoneal dissemination. These nodules were endoscopically resected. Pathological examination of the nodules confirmed the peritoneal dissemination of gastric cancer. Diagnostic laparoscopy has a great advantage in the diagnosis of the peritoneal recurrence at an early stage, because it is easy and allows detailed inspection with minimal invasion.

Key words
peritoneal recurrence of gastric cancer, diagnostic laparoscopy

Reprint requests
Osamu Kobayashi Department of Surgery, Kanagawa Cancer Center Hospital
1-1-2 Nakao, Asahiku, Yokohama, 241-0815 JAPAN

Accepted
July 22, 1998

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