title: Synchronous double cancer of the stomach and rectum with situs inversus totalis and polysplenia syndrome.
abstract: Situs solitus refers to the normal arrangement of body organs. Situs inversus totalis is a complete mirror image or reverse isomeric form of the thoracic and abdominal viscera. Any arrangement of organs between these two extremes is designated by heterotaxia. Several patterns of vascular and visceral abnormalities are associated with heterotaxia, and two loosely defined syndromes of splenic anomalies (asplenia and polysplenia) are most common. We present the case of a 71-year-old woman with situs inversus totalis and polysplenia syndrome who developed synchronous double cancer originating from the stomach and rectum. Abdominal manifestations were situs inversus totalis combined with multiple lobulated spleen, azygous continuation of the interrupted inferior vena cava, direct drainage of hepatic vein to left atrium, preduodenal portal vein, short pancreas, incomplete rotation of the colon, and malrotation of the intestine. Histologically, gastric cancer was diagnosed as papillary adenocarcinoma and rectal cancer, as moderately differentiated adenocarcinoma. The patient was successfully treated with total gastrectomy for gastric cancer and low-anterior resection of the rectum for rectal cancer.
authors.affiliation: Department of Surgery, Miyazaki Prefectural General Hospital, Miyazaki, Japan. tiwamura@post1.miyazaki-med.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Iwamura
authors.forename: N
authors.initials: N
authors.lastname: Shibata
authors.forename: Y
authors.initials: Y
authors.lastname: Haraguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Hisashi
authors.forename: T
authors.initials: T
authors.lastname: Nishikawa
authors.forename: H
authors.initials: H
authors.lastname: Yamada
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.forename: K
authors.initials: K
authors.lastname: Toyoda
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000368:Aged; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D012007:Rectum / Q000473:pathology / Q000601:surgery; D012857:Situs Inversus / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013154:Spleen / Q000002:abnormalities* / Q000000981:diagnostic imaging; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed