Gastric Carcinoma Recurrence 14 Years after Distal Gastrectomy: A Case Report

Abstract

A 64-year-old man with appetite loss seen at a local hospital was referred to Kawaguchi Municipal Medical Center for further investigation. Abdominal CT showed a small pleural effusion and ascites, without any evident neoplastic lesion. Additionally, cervical US revealed a tumor measuring 15 mm in diameter. T2-weighted MR images and PET-CT revealed bone metastases to the spine and left scapula. However, gastrointestinal endoscopy and CT failed to reveal the primary tumor. The patient had undergone gastrectomy for advanced gastric carcinoma 14 years ago. Since the possibility of a metastatic tumor could not be excluded, tumorectomy of the neck was performed. Histopathologically, the excised mass was diagnosed as an adenocarcinoma of the lymph node, which was suggestive of a metastatic lymph node from gastric carcinoma based on its morphological and immunohistopathological features. Metastatic recurrence of gastric cancer over 10 years after gastrectomy is extremely rare. Thus, we describe this case with a review of the literature.