2018 Volume 51 Issue 5 Pages 342-349
A 72-year-old man had undergone total gastrectomy nine years previously, and we diagnosed poorly differentiated adenocarcinoma T2(SS) N1 M0 pStage II according to the Japanese Classification of Gastric Carcinoma, 13th edition. An annual surveillance chest CT revealed a small lesion in the upper lobe of the left lung. Three months later, it grew up to a solid mass of 16×13×11 mm in S3a of the left lung but no swollen lymph nodes were detected. Thoracoscopic partial resection of the left lung was performed and the tumor was intraoperatively diagnosed to be an adenocarcionoma by frozen section. As it was thought to possibly be a primary lung cancer, additional upper lobectomy of the left lung and lymph node dissection was performed. Pathological examination revealed that the tumor was consistent with a metastasis from gastric cancer which was resected nine years previously. Metastatic lung cancer from the stomach is often encountered as lymphangitis carcinomatosa or pleuritis carcinomatosa, but a solitary metastasis is very rare. A metastasis nine years after gastrectomy is even more rare.
