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KMID : 0371320020630020167
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Journal of the Korean Surgical Society
2002 Volume.63 No. 2 p.167 ~ p.170
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Early Gastric Cancer Accompanied with a Giant Metastatic Abdominal Lymph Node
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Park Jong-Woo
Lee Sang-Kuon
Kim Won-Woo
Jeon Hae-Myung
Kim Eung-Kook
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Abstract
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Lymph node metastasis is found in 10-15% of patients with early gastric cancer; however, metastatic nodes forming giant abdominal masses or distant metastases are extremely rare. A 51-year-old male, HBs Ag-positive patient presented with an
incidentally
found huge upper abdominal mass. Imaging studies showed a 7 ㎝-sized epigastric mass consistent with hepatocellular carcinoma. His serum α-fetoprotein level was also significantly elevated (330.6 ng/㎖). Endoscopic studies revealed a suspicious
early
gastric carcinoma located on the lesser curvature and the anterior wall of the antrum. He was operated on with a preoperative diagnosis of hepatocellular carcinoma coexisting with an early gastric carcinoma. However, the actual abdominal tumor was
a
metastatic lymph node resulting from a gastric carcinoma which was located around the hepatic artery. Accordingly, he underwent a subtotal gastrectomy with the D2 lymph node dissection and the removal of the metastatic node. Postoperatively, he did
well
without any complications. His serum α-fetoprotein level decreased to 49.3 ng/㎖ one week after the surgery and was completely normalized 3 months later. To date, one year and 4 months after the operation, he is in good conditions without evidence
of
recurrence on endoscopic and imaging studies.
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KEYWORD
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