A Case of Metastasis to the Right Iliopsoas Muscle after Gastrectomy for Gastric Cancer

Kiyotaka Kawai, Toshio Tamauchi, Eiji Takeuchi and Tetsuya Okamoto

Department of Surgery, Fukuroi Municipal Hospital

In October 1998, a 70-year-old man underwent total gastrectomy with splenectomy and regional lymph node dissection for triple gastric cancers composed of type IIa and IIc lesions in the antral area and a Borrmann type 3 lesion in the middle area. Pathologically, the type IIa lesion was well-differentiated tubular adenocarcinoma (SM, ly2, v1), the type IIc lesion was moderately differentiated tubular adenocarcinoma (SM, ly1, v0), and the Borrmann type 3 lesion was poorly differentiated adenocacinoma (SS, ly2, v1). Final stage grouping was IIIA (T2N2H0P0) based on the general rules of the Japanese gastric cancer study. In November 1999, he reported discomfort in the right lower extremity. Enhanced computed tomography (CT) showed a ring-like tumor in the right iliopsoas muscle. In February 2000, a core needle biopsy specimen of the muscle tumor showed poorly differentiated adenocarcinoma, and he was diagnosed with right iliopsoas muscle metastasis from gastric cancer. In September 2000, he reported a mass on the dorsal side of the left femur. Enhanced CT scan showed a ring-like mass in the left semimembranosus muscle. Core needle biopsy showed poorly differentiated adenocarcinoma and he was diagnosed with left semimembranosus muscle metastasis. He was hereafter diagnosed with left long adductor muscle metastasis in May 2001 and right triceps brachii muscle metastasis, paraaorticlymph node metastasis, and multiple lung metastasis in August 2001. After treatment with radiotherapy and chemotherapy, he has been followed up as an outpatient in December 2001.

Key words
gastric cancer, metastasis, skeletal muscle

Reprint requests
Kiyotaka Kawai Department of Surgery, Fukuroi Municipal Hospital 2515-1 kuno, Fukuroi, 437-0061 JAPAN

Accepted
May 29, 2002

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