内容紹介
A Patient Who Underwent Surgery after CR to Chemotherapy for Scirrhous Gastric Cancer Suspected because of Lymphangitis Carcinomatosa
Summary
A 58-year-old woman was diagnosed with scirrhous gastric cancer suspected because of lymphangitis carcinomatosa. She was treated with 10 courses of S-1+CDDP chemotherapy. After 3 years and 6 months, CR was obtained and she underwent curative total gastrectomy with D2 lymph node dissection plus resection of the spleen and transverse colon. The pathological results of the resected specimen were tub2>por, pT1a, N1(No. 7), M0, CY0, P0, and HER2(3+). After surgical treatment, supraclavicular lymph node metastasis occurred, and the patient underwent trastuzumab+capecitabine therapy, which resulted in CR for 1 year and 6 months. Thus, for unresectable scirrhous gastric cancer, multidisciplinary therapy such as long-term chemotherapy including trastuzumab and surgery is useful.
要旨
症例は58歳,女性。癌性リンパ管症を伴うスキルス胃癌に対し,S-1+CDDP化学療法10コース施行しCRを得た。3年6か月後に根治切除施行。切除標本の病理結果はtub2>por,pT1a,N1(No. 7),M0,CY0,P0,HER2(3+)であった。その後,鎖骨上窩リンパ節再発を来し,trastuzumab+capecitabine併用化学療法施行。1年6か月,画像上病巣は認めていない。切除不能スキルス胃癌に対しても長期にわたる化学療法,手術治療など集学的治療が有用であると考えられた。
目次
Summary
A 58-year-old woman was diagnosed with scirrhous gastric cancer suspected because of lymphangitis carcinomatosa. She was treated with 10 courses of S-1+CDDP chemotherapy. After 3 years and 6 months, CR was obtained and she underwent curative total gastrectomy with D2 lymph node dissection plus resection of the spleen and transverse colon. The pathological results of the resected specimen were tub2>por, pT1a, N1(No. 7), M0, CY0, P0, and HER2(3+). After surgical treatment, supraclavicular lymph node metastasis occurred, and the patient underwent trastuzumab+capecitabine therapy, which resulted in CR for 1 year and 6 months. Thus, for unresectable scirrhous gastric cancer, multidisciplinary therapy such as long-term chemotherapy including trastuzumab and surgery is useful.
要旨
症例は58歳,女性。癌性リンパ管症を伴うスキルス胃癌に対し,S-1+CDDP化学療法10コース施行しCRを得た。3年6か月後に根治切除施行。切除標本の病理結果はtub2>por,pT1a,N1(No. 7),M0,CY0,P0,HER2(3+)であった。その後,鎖骨上窩リンパ節再発を来し,trastuzumab+capecitabine併用化学療法施行。1年6か月,画像上病巣は認めていない。切除不能スキルス胃癌に対しても長期にわたる化学療法,手術治療など集学的治療が有用であると考えられた。