title: Surgical resection of late solitary locoregional gastric cancer recurrence in stomach bed.
abstract: BACKGROUND
  Late-onset and solitary recurrence of gastric signet ring cell (SRC) carcinoma is rare. We report a successful surgical resection of late solitary locoregional recurrence after curative gastrectomy for gastric SRC carcinoma.
  
  
  METHODS
  The patient underwent total gastrectomy for advanced gastric carcinoma at age 52. Seven years after the primary operation, he visited us again with sudden onset of abdominal pain and vomiting. We finally decided to perform an operation, based on a diagnosis of colon obstruction due to the recurrence of gastric cancer by clinical findings and instrumental examinations. The laparotomic intra-abdominal findings showed that the recurrent tumor existed in the region surrounded by the left diaphragm, colon of splenic flexure, and pancreas tail. There was no evidence of peritoneal dissemination, and peritoneal lavage fluid cytology was negative. We performed complete resection of the recurrent tumor with partial colectomy, distal pancreatectomy, and partial diaphragmectomy. Histological examination of the resected specimen revealed SRC carcinoma, identical in appearance to the previously resected gastric cancer. We confirmed that the intra-abdominal tumor was a locoregional gastric cancer recurrence in the stomach bed. The patient showed a long-term survival of 27 months after the second operation.
  
  
  CONCLUSIONS
  In the absence of effective alternative treatment for recurrent gastric carcinoma, surgical options should be pursued, especially for late and solitary recurrence.
authors: Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan. margaux82@nifty.com
authors: Masanori
authors: M
authors: Watanabe
authors: Hideyuki
authors: H
authors: Suzuki
authors: Kentaro
authors: K
authors: Maejima
authors: Osamu
authors: O
authors: Komine
authors: Satoshi
authors: S
authors: Mizutani
authors: Masanori
authors: M
authors: Yoshino
authors: Hideki
authors: H
authors: Bo
authors: Yasuhiko
authors: Y
authors: Kitayama
authors: Eiji
authors: E
authors: Uchida
mesh_terms: D004733:Enema; D005743:Gastrectomy; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery*; D010641:Phenotype; D013270:Stomach / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D009077:Mucins