The Gastrectomy for a Gastric Cancer Led to a Remission of Nephrotic Syndrome: A Case Report

Tadafumi Asaoka, Shigeo Matsui, Takashi Iwazawa, Yutaka Kimura, Toshiyuki Kano, Tadashi Onishi, Takeshi Tono, Yoshiaki Nakano, Hiroshi Yano and Takushi Monden

Department of Surgery, NTT West Osaka Hospital

A 66-year-old man with bilateral leg edema and food passage failure was diagnosed with advanced gastric cancer with nephrotic syndrome (membranouse nephropathy). Although he was found during surgery to have liver metastases and peritoneum dissemination, he underwent total gastrectomy to improve anemia and food passage failure. Histology showed moderately differentiated tubular adenocarcinoma with nodal metastases. Urinary protein decreased 2 weeks postoperatively and signs and symptoms of nephrotic syndrome improved. Nephrotic syndrome has been suggested to be associated with malignant tumors induced by deposits of cancer antigen-antibody complexes in the glomerula. Insofar as we could found in a review of the literature, operations for gastric cancer resulting in nephrotic syndrome remission numbered 17, including our case. Nephrotic syndrome rarely improves, although this case involved noncurative treatment. This case is of interest in determining surgery for gastric cancer with nephrotic syndrome.

Key words
nephrotic syndrome, membranous nephropathy, gastric cancer

Reprint requests
Tadafumi Asaoka Department of Surgery, NTT West Osaka Hospital
2-6-40 Karasugatsuji, Tennoji, Osaka, 543-8922 JAPAN

Accepted
May 25, 2004

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