title: [A Case of T1a Early Gastric Cancer That Metastasized to the Right Femoral Muscles Six Years and Seven Months after Radical Surgery].
abstract: A 49-year-old woman presented to our hospital complaining of abdominal distension and right thigh edema 6 years and 7 months after undergoing total gastrectomy for early gastric cancer in December 2008. The histopathological type of the tumor was poorly differentiated adenocarcinoma. The pathological findings led to a diagnosis of T1aN2M0, Stage II A disease. In August 2015, abdominal CT and MRI revealed para-aortic lymph node swelling, ascites, and a tumor on the right femoral muscles. We performed a needle biopsy of the femoral muscle, and the final diagnosis was intramuscular metastasis from the primary gastric cancer. We initiated chemotherapy using TS-1 plus docetaxel. TS-1(80mg/m2/day)was orally administered for 2 weeks followed by a 1-week drug-free period, and 1 course of docetaxel(40mg/m2)was administered intravenously on day 1. After 2 courses of this regimen, the tumor on the right femoral muscles was reduced in size. However, diarrhea and leukopenia were observed, and the treatment schedule was changed to several other chemotherapy regimens. The patient died of progressive disease 6 months after the diagnosis of muscle metastasis. We report a rare case of late recurrence after curative resection in a patient treated for T1a early gastric cancer.
authors.affiliation: Dept. of Surgery, Suita Municipal Hospital.
authors.forename: Chikara
authors.initials: C
authors.lastname: Ebisui
authors.forename: Rie
authors.initials: R
authors.lastname: Hamano
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Nushijima
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Shu
authors.initials: S
authors.lastname: Okamura
authors.forename: Nariaki
authors.initials: N
authors.lastname: Fukuchi
authors.forename: Kohei
authors.initials: K
authors.lastname: Murata
authors.forename: Hideoki
authors.initials: H
authors.lastname: Yokouchi
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Kinuta
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Ohishi
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D005269:Femur / Q000473:pathology*; D005743:Gastrectomy; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D012008:Recurrence; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D013997:Time Factors