Abstract
A 75-year-old woman was found to have elevated serum CEA of 203ng/ml and elevated CA19-9 of 2, 090U/ml after mastectomy, but no reccurence of breast cancer. Gastroendoscopic examination showed a IIa+III lesion 6cm in diameter in the upper third of the posterior gastric wall. Biopsy and histopathological examination suggested poorly differentiated adenocarcinoma, necessitating total gastrectomy, splenectomy, and distal pancreatectomy in April 2001.The main tumor, which was white and fragile, was confined to the submucosal layer with no distant metastasis observed, but clinical stage IV, lymph node metastasis was seen along the proximal and distal splenic artery. In immunohistochemistry, tumor cells of both the tumor and metastatic lymph nodes stained strongly for CA19-9.Serum CA19-9 quickly normalized, and the woman remains alive 5 years after surgery.
