A case of metachronous liver metastasis from neuroendocrine carcinoma of the stomach at 1 year and 10 months after endoscopic submucosal dissection.
A 77-year-old man underwent endoscopic submucosal dissection (ESD) of a type 0-IIc tumor located in the cardiac part of the stomach. The pathological diagnosis of the tumor was poorly differentiated tubular adenocarcinoma with submucosal invasion depth;therefore, radical gastrectomy was also performed. After 1 year and 10 months, liver metastasis was detected because of which partial liver resection was performed. The pathological diagnosis of the tumor was neuroendocrine carcinoma (NEC). The pathology of the ESD specimen was re-examined, and a diagnosis of gastric NEC was made;furthermore, the liver tumor was regarded as metachronous metastasis. Despite the radical excision of the stage IA tumor, metastasis occurred. Chemotherapy with S-1 alone was successfully performed after the liver resection while considering the advanced age of the patient. Follow-up revealed no signs of recurrence at 1 year and 4 months after the treatment, indicating that the S-1 therapy may be considered for treating NEC in elderly and medically compromised patients owing to its mild side effects.
Department of Gastroenterology, Kirishima Medical Center.
Masafumi
M
Hashiguchi
Tsutomu
T
Tamai
Yuuichiro
Y
Nasu
Fumisato
F
Sasaki
Michiyo
M
Higashi
Kaoru
K
Hijikuro
Hisatomo
H
Futawatari
Kouichirou
K
Shigeta
Susumu
S
Hasegawa
Akio
A
Ido
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D018278:Carcinoma, Neuroendocrine / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004338:Drug Combinations; D000069916:Endoscopic Mucosal Resection; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D010094:Oxonic Acid / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005641:Tegafur / Q000627:therapeutic use; D013997:Time Factors
D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid