Serous Surface Papillary Carcinoma of the Peritoneum followed by Solitary Metastasis to the Stomach during Adjuvant Chemotherapy; Report of a Case

Toru Kimura, Kazuhiro Nishikawa, Kazuhiro Iwase, Toyokazu Aono, Sumio Nakai, Makoto Fujii, Chu Matsuda, Hayato Kimura*, Shoki Mikata** and Yasuhiro Tanaka

Department of Surgery and Department of Pathology*, Osaka General Medical Center
Department of Surgery, Osaka Rosai Hospital**

A 59-year-old woman with discomfort in sexual intercourse, elevated serum CA125, and ascites, underwent neoadjuvant chemotherapy with 3 courses of CBDCA/TXL followed by bilateral salpingo-oophorectomy, omentectomy, and lymphadenectomy of intrapelvic and paraaortic lymph nodes based on a diagnosis of serous surface papillary carcinoma of the peritoneum (SSPC). Adjuvant chemotherapy with the same regimen was added. Repeatedly increased intraabdominal masses and serum CA125 continued. In January 2007, she reported epigastric fullness and serum CA125 rose again. Abdominal CT showed a mass 2 cm in diameter at the gastric antrum, and upper gastrointestinal endoscopy showed a submucosal tumor-like lesion at the posterior wall of the pyloric antrum, necessitating partial gastrectomy in May 2007 based on a diagnosis of gastric submucosal tumor or metastatic lesion from SSPC. Macroscopic findings showed the mucosal layer of the stomach to be intact, suggesting a primary gastric submucosal tumor. However, pathological examinations showed the tumor to be a metastatic SSPC lesion. No recurrent lesion has been detected in the 6 months since removal of the metastatic gastric lesion.

Key words
serous surface papillary carcinoma, metastasis, stomach

Reprint requests
Toru Kimura Department of Surgery, Osaka General Medical Center
3-1-56 Mandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558 JAPAN

Accepted
February 20, 2008

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