title: [Gastric Cancer Diagnosed with Metastasis of the Navel(Sister Mary Joseph's Nodule) - A Case Report].
abstract: A woman in her 60s was admitted to our hospital with pain and induration of the navel. She was diagnosed with gastric cancer with metastasis to the navel and underwent total gastrectomy and navel extraction. Because disseminated nodules were detected in the Douglas pouch and sigmoid colon, sigmoidectomy was performed to prevent bowel obstruction. The navel tumor was histologically diagnosed as a metastasis of the gastric cancer. One month after surgery, a chest skin tumor, which was also a skin metastasis of the gastric cancer[T4aN3M1(SKI, OTH)H0P1, fStage IV ], was detected, and tumor enucleation was performed. Enucleation was followed by 47 courses of systemic chemotherapy consisting of capecitabine, cisplatin, and trastuzumab. No recurrence or metastasis has been observed via FDG-PET/CT as of 5 years after surgery. Gastric cancer with peritoneal dissemination in addition to navel metastasis has been reported to have an extremely poor prognosis. However, long-term, recurrence-free survival was obtained in this case owing to aggressive surgical resection, followed by persistent systemic chemotherapy.
authors.affiliation: Dept. of Surgery, Kobe Ekisaikai Hospital.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Katayama
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ishii
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tono
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okubo
authors.forename: Koji
authors.initials: K
authors.lastname: Shinozaki
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Shuho
authors.initials: S
authors.lastname: Senba
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasuda
authors.forename: Minoru
authors.initials: M
authors.lastname: Otsuru
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069287:Capecitabine / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005743:Gastrectomy; D006801:Humans; D058288:Sister Mary Joseph's Nodule / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D012878:Skin Neoplasms / Q000188:drug therapy; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D000068878:Trastuzumab / Q000008:administration & dosage
chemical_list: D000069287:Capecitabine; D000068878:Trastuzumab; D002945:Cisplatin