Gastric Cancer with Duodenal Intramural Metastasis: A Case Report

Kazuki Mizutani, Toshiharu Beppu, Takamasa Fukumitsu, Eizoh Kai, Jyunji Ohta, Issei Kodama, Masanori Nehdomi, Koji Shiota^* and Kazuo Shirouzu^**

Department of Surgery, and Pathology^* Yame General Hospital Department of Surgery, Kurume University School of Medicine^**

We present a rare case of gastric cancer with duodenal intramural metastasis. A 75-year-old man was referred to our hospital with a gastric tumor diagnosed by endoscopy. On admission, esophagogastroscopy confirmed that the cancerous lesion was type-3, and occupied the middle-third of the lesser curvature of the stomach, and also found a submucosal tumor in the duodenal bulbus. Furthermore, endoscopic biopsy confirmed the diagnosis of a poorly differentiated adenocarcinoma, but no evidence of malignancy was found in the duodenal lesion. Since diagnosis of the duodenal tumor as a leiomyosarcoma could not be ruled out, the lesion was resected. We performed total-gastrectomy, including the duodenal lesion, with ρ-Roux-Y reconstruction. Later, it was confirmed that the gastric lesion and duodenal lesion were the same poorly-differentiated adenocarcinoma histopathologically. Therefore, final diagnosis was duodenal intramural metastasis from gastric cancer.

Key words
gastric cancer, duodenal intramural metastasis

Reprint requests
Kazuki Mizutani Department of surgery, Yame general Hospital 540-2 Takatsuka, Yame-shi, 834-0034 JAPAN

Accepted
May 23, 2000

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