Abstract
A 67-year-old man was admitted to our hospital due to right lower abdominal discomfort. Endoscopic examination revealed type 2 gastric cancer at the prepylorus. Although preoperative computed tomography (CT) and ultrasonography (US) did not detect liver metastasis, multiple small white nodules 2 to 3 mm in size were found over the whole liver, and diagnosed as liver metastasis of gasteic cancer by intraoperative histological examination of frozen tissue. Distal gastrectomy with regional lymph node dissection was done. A port for hepatic arterial infusion was also implanted. 5-FU, ADM, MMC, and Lentinan were administered via the hepatic artery every 2 weeks for 5 years. Liver metastasis was not detected with any image examination until the man's death. Lung metastasis appeared on chest radiograph as a solitary mass in the right lower lung 3 years after surgery. Palliative radiation therapy was done for hemoptysis. He received systemic chemotherapy with leucovorin and 5-FU thereafter. He eventually died of brain metastasis 7 years and 9 months aftrer gastrectomy. This case suggests that local and systemic chemotherapy is effective in some gastric cancer cases with liver metastasis.
