[A Case of Advanced Gastric Cancer with Umbilical Metastasis, Pyloric Stenosis, and Peritoneal Dissemination Underwent Palliative Surgery after Chemotherapy].

Abstract

A 62-year-old woman was diagnosed with gastric cancer, Type 4, cT4b(LN, mesentery of transverse colon), N1 M1H0P1CY1, cStage ⅣB. S-1 and L-OHP(SOX)were administered for 4 courses and clinical response was SD. She interrupted the treatment because of practicing folk therapy. She had an emergency hospitalization due to pyloric stenosis, vomiting, and an umbilical tumor with pain. She was treated with 1 course of mFOLFOX6(5-FU, L-OHP, l-LV)followed by palliative surgery(laparoscopy assisted distal gastrectomy, Roux-en-Y reconstruction, resection of umbilical tumor, and bypass for transverse colon stenosis due to dissemination). The pathological diagnosis was L, Circ, Type 4, 126×89 mm, por> sig, pT4b(SI, mesentery of transverse colon), pN3a(12/13), H0P1CY1, pStageⅣ, and metastatic umbilical tumor. Following surgery, oral administration of mFOLFOX6 is continued. Umbilical metastasis(Sister Mary Joseph's nodule)is associated with poor prognosis, however, appropriate management including symptom control by palliative surgery and continuation of chemotherapy may lead a better prognosis.

• Authors: Chikako Kusunoki, Takuya Hamakawa, Masayuki Mano, Kazuhiro Nishikawa, Reishi Toshiyama, Masaaki Miyo, Ayako Fujiwara, Masakazu Miyake, Naoki Hama, Atsushi Miyamoto, Takeshi Kato, Koji Takami, Motohiro Hirao
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 47 Issue 3 Pg. 513-515 (Mar 2020) ISSN: 0385-0684 [Print] Japan
• PMID: 32381933 (Publication Type: Case Reports, Journal Article)

Topics

• Combined Modality Therapy
• Female
• Humans
• Middle Aged
• Palliative Care
• Peritoneal Neoplasms (secondary)
• Pyloric Stenosis (etiology, therapy)
• Sister Mary Joseph's Nodule
• Stomach Neoplasms (complications, therapy)
• Umbilicus