A Case Report of Umbilical Metastasis of Gastric Cancer at Ten Years after Total Gastrectomy

Kenichi Matsuzu, Yasunobu Yamazaki, Satoshi Hasegawa, Hideyuki Ike, Nobuko Nakamura¹⁾, Norio Yukawa²⁾, Yasushi Rino²⁾ and Munetaka Masuda²⁾

Department of Surgery and Department of Pathology¹⁾, Saisei-kai Yokohama-shi Nanbu Hospital
Department of Surgery, Yokohama City University School of Medicine²⁾

Both gastric cancer recurrence over 10 years after initial surgery and umbilical metastasis known as Sister Mary Joseph's nodule are rare. We report an unusual case of umbilical gastric cancer metastasis over 10 years after surgery. A 50-year-old woman who underwent total gastrectomy (curativity B) in June 1996 was diagnosed postoperatively as pathological StageIII_A (poorly differentiated adenocarcinoma (por2), T3 (SE), N1, H0, P0, M0). Adjuvant chemotherapy with UFT was administered for five years without evident recurrence. After reporting left back pain and an umbilical tumor in August 2006, she was found in computed tomography (CT) to have left hydronephrosis and a 1.2 cm umbilical tumor. Based on the diagnosis of peritoneal dissemination and umbilical gastric cancer metastasis, she was treated with TS-1 and cisplatin (CDDP) combined chemotherapy. Hydronephrosis disappeared after one course, but the umbilical tumor grew and paclitaxel was ineffective. The woman died in September 2001.

Key words
gastric cancer, late recurrence, Sister Mary Joseph's nodule

Reprint requests
Kenichi Matsuzu Department of Surgery, Yokohama City University Hospital and Medical Center
3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 JAPAN

Accepted
May 19, 2010

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