Spleen Metastasis Occurred in 3 years after Resection of Remnant Gastric Cancer

Hidemitsu Sugai, Koji Kono and Hideki Fujii

First Department of Surgery, University of Yamanashi

We report a resected case of metachronous splenic metastasis from remnant gastric cancer in 63-year-old man who had undergone distal gastrectomy reconstructed with the Billroth-II method for a gastric ulcer in 1970. In October 1998, he suffered from advanced gastric cancer (B-30-A, Type 3, T3 (SE), N3 (NoJ2) H0, P0, MO) in the remnant stomach, necessitating total resection of the remnant stomach followed by Roux-en-Y reconstruction and partial resection of the transverse colon. He was followed up and treated by systemic chemotherapy. After 26 months, computed tomography showed a solitary splenic tumor 3 cm in diameter with increased CEA tumor marker. Under a diagnosis of splenic metastasis from the remnant gastric cancer, we conducted a splenectomy. Histopathological examination showed well and moderately differentiated adenocarcinoma in the spleen, histologically compatible with the metastasis from remnant gastric cancer. He remains recurrence free 15 months later.

Key words
remnant gastric cancer, spleen metastasis

Reprint requests
Hidemitsu Sugai First Department of Surgery, University of Yamanashi
1110 Shimokato, Tamahocho, Nakakomagun, Yamanashi, 409-3898 JAPAN

Accepted
July 23, 2003

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