title: Gastric cancer with cervical lymph node metastasis as the first presentation: report of a case.
abstract: A 62-year-old man presented with a painful left lateral neck mass. Aspiration cytology revealed lymph node metastasis of undifferentiated carcinoma. A Borrmann type 3 tumor was detected in the body of the stomach on endoscopic examination. No visceral metastasis was found. Distal gastrectomy and radical neck dissection were performed. Pathological examination revealed that the histological features of the gastric lesion were identical to those of the cervical lymph node lesion. Regional lymph nodes of the stomach and Virchow's lymph nodes were not involved. Irradiation to the left supraclavicular and cervical region and an oral tegafur anticancer agent (TS-1) were started. Left axillary and right supraclavicular lymphadenopathies were detected 4 and 5 months after surgery, respectively. Rapid progression of hoarseness was observed, and weekly docetaxcel was started. However, he died of airway obstruction 8 months after surgery.
authors: Department of Surgery, Osaka Socio-Medical Center, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka, Japan. tsutomu-@rd5.so-net.ne.jp
authors: Tsutomu
authors: T
authors: Takashima
authors: Bunzo
authors: B
authors: Nakata
authors: Masahiro
authors: M
authors: Hatama
authors: Shinya
authors: S
authors: Nomura
authors: Masahiro
authors: M
authors: Komoto
authors: Tetsuro
authors: T
authors: Ishikawa
authors: Kosei
authors: K
authors: Hirakawa
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D005743:Gastrectomy; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D007601:Jugular Veins / Q000473:pathology; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D014826:Vocal Cord Paralysis / Q000453:epidemiology