A Case Report of Early Gastric Cancer with Widespread Metastasis

Ryoichi Akimoto, Noboru Mizobuchi, Shoji Tsuchiya, Heiwa Furuya, Tadamitsu Yamasaki, Noburu Sakakibara

The First Department of Surgery, Juntendo University School of Medicine

According to the General Rules for the Gastric Cancer Study of the Japanese research Society for Gastric Cancer, in early gastric cancer invasion of the tumor is limited to the mucosa or the mucosa and submucosa of the stomach. But we experienced a very rare case of early gastric cancer which metastasized to not only the inguinal lymph nodes but also the bilateral ovaries. The patient was a 53-year-old woman from whom a biopsy specimen was taken from a right inguinal lymph node and given a diagnosis of signet-ring cell carcinoma. Its primary lesion was in the antrum of the stomach. Although the invasion of the gastric wall was limited to within the submucosal layer, lymph nodes metastasis spread to the paraaortic and inguinal regions. Five months after gastrectomy, a reoperation was performed because of metastatic ovarian tumors. The patient died six months after the reoperation from pnumonitis and peritonitis carcinomatosa. In Japan, 12 cases of superficial gastric cancer with lymph node metastases beyond the paraaortic region, including this case, have been reported. Furthermore, only six patients with superficial gastric cancer had ovarian metastases. This case is a really rare one from the concept of early gastric cancer. In order to think about the prognosis of early gastric cancer like these cases, considering each of their stages might be very important.

Key words
distant lymph node metastasis of early gastric cancer, ovarian metastasis of early gastric cancer

Reprint requests
Ryoichi Akimoto Department of Surgery, Juntendo Izunagaoka Hospital
1129 Nagaoka, Izunagaoka-cho, Tagata-gun, Shizuoka, 410-22 JAPAN

Accepted
September 12, 1990

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