title: A patient with small-cell carcinoma of the stomach with long survival after percutaneous microwave coagulating therapy (PMCT) for liver metastasis.
abstract: A 66-year-old man was admitted to our hospital with epigastralgia. Preoperative examinations revealed an 8.0 x 8.0-cm, Borrmann type 2 tumor in the posterior wall of the cardia, without distant metastases. Total gastrectomy with pancreato-splenectomy and regional lymph node dissection was performed curatively. Histologically, the tumor was composed mainly of small cells with hyperchromatic nuclei and scant cytoplasm, which showed positive staining for Grimelius, gamma-neuron-specific enolase (gamma-NSE), chromogranin A, and serotonin. About 10 months after the operation, a solitary tumor was revealed in S8 of the liver by abdominal computed tomography (CT), and it was histologically confirmed by needle biopsy to be a metastasis of the small-cell carcinoma from the stomach. Instead of hepatectomy, percutaneous microwave coagulating therapy (PMCT) was indicated, because of the patients' liver dysfunction (ICG R15, 39.9%); CT showed complete necrosis of the metastatic focus in the liver after the PMCT. Now, 33 months after the first detection of the liver metastasis (43 months after the gastrectomy), the patient is still alive without any growth of the liver metastasis. The 67 previously reported cases of small-cell carcinoma of the stomach in Japan, including ours, are also reviewed.
authors.affiliation: Department of Surgery, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu 500-8513, Japan. htanemura@gmhosp.gifu.gifu.jp
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tanemura
authors.forename: Hiroo
authors.initials: H
authors.lastname: Ohshita
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kanno
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Kusakabe
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tomita
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nishigaki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sugiyama
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018288:Carcinoma, Small Cell / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D004564:Electrocoagulation; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008197:Lymph Node Excision; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed