title: [Remission of Advanced Gastric Cancer with Concurrent Portal Vein Tumor Thrombosis via Chemotherapy - A Case Report].
abstract: The following is a case report of moderately differentiated tubular adenocarcinoma of the stomach with widespread thrombosis of the portal vein, for which chemotherapy proved effective. A 75-year-old man presented to the clinic with a new onset ofmalaise. The patient had anemia, elevation ofliver and biliary enzymes, and significantly elevated CA19-9 levels at 43,581 U/mL and CEA levels at 2,560 ng/mL. An upper endoscopy revealed a mass lesion extending from the fundus to the pylorus as well as to the duodenum along the smaller curvature of the stomach. A biopsy revealed moderately differentiated tubular adenocarcinoma. Abdominal CT showed a mass lesion extending from the body of the stomach and penetrating through the gastric wall, and extensive lymphadenopathy in the surrounding areas. In addition, multiple thromboses were identified in the portal vein and its tributaries, including the inferior mesenteric vein, splenic vein, and intrahepatic capillaries. The patient subsequently received a single round ofS -1 and CDDP. The tumor demonstrated a marked response; the tumor size and lymphadenopathy showed a significant improvement and the CA19-9 level decreased. Because the patient's condition deteriorated, this chemotherapy regimen was discontinued. The patient was switched to S-1 monotherapy and is still alive today, 2 years 10 months after the initial diagnosis.
authors.affiliation: Dept. of Surgical Oncology, Kanazawa Medical University.
authors.forename: Seiko
authors.initials: S
authors.lastname: Miura
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Ueda
authors.forename: Hideto
authors.initials: H
authors.lastname: Fujita
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kinami
authors.forename: Takeo
authors.initials: T
authors.lastname: Kosaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Funaki
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakata
authors.forename: Ryuhei
authors.initials: R
authors.lastname: Nishino
authors.forename: Wataru
authors.initials: W
authors.lastname: Koda
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D006801:Humans; D008297:Male; D010094:Oxonic Acid / Q000008:administration & dosage; D011169:Portal Vein / Q000473:pathology*; D013274:Stomach Neoplasms / Q000098:blood supply* / Q000150:complications / Q000188:drug therapy*; D005641:Tegafur / Q000008:administration & dosage; D020246:Venous Thrombosis / Q000209:etiology*
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin