title: Giant Krukenberg tumor from a perforated gastric cancer that was successfully removed after multidisciplinary therapy: report of a case.
abstract: A 46-year-old female underwent total gastrectomy with a combined resection of the pancreatic tail, spleen, and lateral segment of the liver surgery after conservative medical management for a perforated advanced gastric cancer. The histological findings showed poorly differentiated adenocarcinoma, and the tumor was Stage IIIC. S-1 and "Kampo-Juzen-taiho-to" were administered as postoperative adjuvant chemo-immunotherapy. A Krukenberg tumor was identified 4 years later. The histological findings strongly suggested the presence of peritoneal dissemination, and S-1-based combined chemotherapies using key drugs such as CDDP, CPT-11, and taxane with the biochemical response modifier "Lentinan" was administered. However, the Krukenberg tumor rapidly increased in size after 4 years and she complained of abdominal distension. Therefore, it was removed with neither difficulties nor apparent recurrent disease, which was thought to be due to the S-1-based combined chemotherapy and the immunological agents are likely to have contributed to her long survival and good quality of life.
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, 503-8502, Gifu, Japan, masaki19sunagawa79@gmail.com.
authors.forename: Masaki
authors.initials: M
authors.lastname: Sunagawa
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Isogai
authors.forename: Tohru
authors.initials: T
authors.lastname: Harada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kaneoka
authors.forename: Keitaro
authors.initials: K
authors.lastname: Kamei
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Maeda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takayama
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007167:Immunotherapy; D007725:Krukenberg Tumor / Q000556:secondary* / Q000628:therapy*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000556:secondary* / Q000628:therapy*; D010052:Ovariectomy; D010094:Oxonic Acid / Q000008:administration & dosage; D008517:Phytotherapy; D011182:Postoperative Care; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; C063587:juzentaihoto; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid