title: Early gastric cancer with suspected brain metastasis arising eight years after curative resection: a case report.
abstract: BACKGROUND
  Brain metastasis from gastric cancer is fairly uncommon and prognosis is dismal. We report a case of early gastric cancer with brain metastasis arising 8 years after gastrectomy.
  
  
  METHODS
  A 78-year-old Japanese female presented to our hospital complaining of dizziness, 8 years after undergoing gastrectomy for gastric cancer. Histopathological type of the tumor was well-differentiated adenocarcinoma. Final TNM classification was T1b(sm1)N0M0, and pathological stage was IA. Further examination revealed a metastatic tumor in the cerebellum and multiple liver metastases. The brain metastasis was treated using radiotherapy and steroid. Systemic treatment for liver metastases was performed using the oral fluoropyrimidine drug S-1. Neurological symptoms decreased, enabling the patient to be discharged from hospital. However, chemotherapy was discontinued due to loss of appetite and general fatigue. She died 5 months after the diagnosis of brain metastasis due to progressive disease.
  
  
  CONCLUSIONS
  Cases of brain metastasis arising 8 years after gastrectomy for early gastric cancer have rarely reported. Aggressive treatment for brain metastases may be effective for improvement of the damage to neurological function and quality of life.
authors.affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka City, Osaka 545-8585, Japan. m1157473@med.osaka-cu.ac.jp.
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Sakurai
authors.forename: Kazuya
authors.initials: K
authors.lastname: Muguruma
authors.forename: Akihiro
authors.initials: A
authors.lastname: Murata
authors.forename: Takahiro
authors.initials: T
authors.lastname: Toyokawa
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Amano
authors.forename: Naoshi
authors.initials: N
authors.lastname: Kubo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yashiro
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maeda
authors.forename: Masaichi
authors.initials: M
authors.lastname: Ohira
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology; D008279:Magnetic Resonance Imaging; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed